MEDICARE: AADYA PHARMACY LLC

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	333600000X	Pharmacy

General Provider Information

NPI Number	:	1770956880
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AADYA PHARMACY LLC

Provider Business Mailing Address
First Line	:	1805 5TH AVE
Second Line	:
City	:	BAY SHORE
State	:	NY
Zip	:	11706-1761
Country	:	US
Telephone Number	:	631-231-4960
Fax Number	:	631-231-0368

Provider Business Practice Location Address
First Line	:	1805 5TH AVE
Second Line	:
City	:	BAY SHORE
State	:	NY
Zip	:	11706-1761
Country	:	US
Telephone Number	:	631-231-4960
Fax Number	:	631-231-0368

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RAJESWARA DONEPUDI
Credential	:
Telephone Number	:	631-231-4960

Provider Enumeration Date	:	11/11/2015
Last Update Date	:	11/11/2015

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