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NPI Code Detail

MEDICARE: MILLEN REDDA

MEDICARE: MILLEN REDDA
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
13336C0003XCommunity/Retail Pharmacy0202213871VA

General Provider Information

NPI Number : 1740885052
Entity Type Code : Individual
Provider Name (Legal Business Name) : MILLEN REDDA
Provider Business Mailing Address
First Line : 5101 DUKE ST
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22304-2905
Country : US
Telephone Number : 703-823-7430
Fax Number :
Provider Business Practice Location Address
First Line : 5101 DUKE ST
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22304-2905
Country : US
Telephone Number : 703-823-7430
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2020
Last Update Date : 12/03/2020

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Directions to “ MILLEN REDDA ” Practice Location

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