MEDICARE: HARI PRIYA RAMINENI

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	PH60544598	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5302040407	OTHER	MI	PHARMACY

General Provider Information

NPI Number	:	1538536024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HARI PRIYA RAMINENI

Provider Business Mailing Address
First Line	:	2020 HINSON LOOP RD APT 228
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72212-3953
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2020 HINSON LOOP RD APT 228
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72212-3953
Country	:	US
Telephone Number	:	604-495-6765
Fax Number	:

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

Provider Enumeration Date	:	08/31/2015
Last Update Date	:	11/28/2015

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Directions to “ HARI PRIYA RAMINENI ” Practice Location

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