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NPI Code Detail

MEDICARE: MS. INDRADEVI SWAMINATHAN RPH

MEDICARE: MS. INDRADEVI SWAMINATHAN RPH
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
1183500000XPharmacistRPH-0012732OR

General Provider Information

NPI Number : 1629346895
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. INDRADEVI SWAMINATHAN RPH
Provider Business Mailing Address
First Line : 514 NE 181ST AVE
Second Line : RITE AID, STORE # 5357 ,
City : PORTLAND
State : OR
Zip : 97230-6702
Country : US
Telephone Number : 503-661-6991
Fax Number :
Provider Business Practice Location Address
First Line : 514 NE 181ST AVE
Second Line : RITE AID, STORE # 5357 ,
City : PORTLAND
State : OR
Zip : 97230-6702
Country : US
Telephone Number : 503-661-6991
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2011
Last Update Date : 01/10/2013

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