MEDICARE: MR. GANESH INAPAKOLLA PHARMAIST

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
1	183500000X	Pharmacist	20293	NC

General Provider Information

NPI Number	:	1093947673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GANESH INAPAKOLLA PHARMAIST

Provider Business Mailing Address
First Line	:	16 HICKORY AVE APT E3
Second Line	:
City	:	BERGENFIELD
State	:	NJ
Zip	:	07621-4621
Country	:	US
Telephone Number	:	336-790-8163
Fax Number	:

Provider Business Practice Location Address
First Line	:	563 E TREMONT AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10457-4655
Country	:	US
Telephone Number	:	718-466-4700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2009
Last Update Date	:	11/07/2013

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