MEDICARE: MR. SEETHARAMARAJU GADIRAJU PHARMACIST

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	5302034992	MI

General Provider Information

NPI Number	:	1841426467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SEETHARAMARAJU GADIRAJU PHARMACIST

Provider Business Mailing Address
First Line	:	RITE AID PHARMACY 4345, 27401 WEST 6 MILE RD
Second Line	:
City	:	LIVONIA
State	:	MI
Zip	:	48152-3834
Country	:	US
Telephone Number	:	734-762-0627
Fax Number	:	734-762-0631

Provider Business Practice Location Address
First Line	:	RITE AID PHARMACY 4345
Second Line	:	27401 WEST SIX MILE RD
City	:	LIVONIA
State	:	MI
Zip	:	48152-3834
Country	:	US
Telephone Number	:	734-762-0627
Fax Number	:	734-762-0631

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

Provider Enumeration Date	:	06/10/2009
Last Update Date	:	06/10/2009

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