MEDICARE: MANJULA CHITKULA 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
1	183500000X	Pharmacist	PH100001270	DC

General Provider Information

NPI Number	:	1871182873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANJULA CHITKULA RPH

Provider Business Mailing Address
First Line	:	8104 WINDING ROSS WAY
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-5529
Country	:	US
Telephone Number	:	479-426-0978
Fax Number	:

Provider Business Practice Location Address
First Line	:	1841 COLUMBIA RD NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20009-2059
Country	:	US
Telephone Number	:	202-795-9711
Fax Number	:	202-897-2250

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

Provider Enumeration Date	:	01/13/2021
Last Update Date	:	01/13/2021

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