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NPI Code Detail

MEDICARE: MR. VENKATA SATYA BHUPATHIRAJU

MEDICARE: MR. VENKATA SATYA BHUPATHIRAJU
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistS017045AZ

General Provider Information

NPI Number : 1073845137
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. VENKATA SATYA BHUPATHIRAJU
Provider Business Mailing Address
First Line : 1618 GOLDRUSH RD APT 241
Second Line :
City : BULLHEAD CITY
State : AZ
Zip : 86442-8390
Country : US
Telephone Number : 928-234-2686
Fax Number :
Provider Business Practice Location Address
First Line : 2360 HIGHWAY 95
Second Line :
City : BULLHEAD CITY
State : AZ
Zip : 86442-7303
Country : US
Telephone Number : 928-763-5858
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2010
Last Update Date : 02/01/2010

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