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NPI Code Detail

MEDICARE: JHANSI LAKSHMI CHINNAM RPH

MEDICARE: JHANSI LAKSHMI CHINNAM 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
1183500000XPharmacist19502MD
2183500000XPharmacistPH232441MA

General Provider Information

NPI Number : 1750674933
Entity Type Code : Individual
Provider Name (Legal Business Name) : JHANSI LAKSHMI CHINNAM RPH
Provider Business Mailing Address
First Line : 10119 OLD OCEAN CITY BLVD
Second Line : RITEAID#319
City : BERLIN
State : MD
Zip : 21811-1143
Country : US
Telephone Number : 410-629-0539
Fax Number : 410-629-0554
Provider Business Practice Location Address
First Line : 10119 OLD OCEAN CITY BLVD
Second Line : RITEAID#319
City : BERLIN
State : MD
Zip : 21811-1143
Country : US
Telephone Number : 410-629-0539
Fax Number : 410-629-0554
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2011
Last Update Date : 05/23/2011

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Directions to “ JHANSI LAKSHMI CHINNAM RPH” Practice Location

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