MEDICARE: MR. AMAR VENKATA NAGA PADMANABHUNI MS 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	A1-0004128	DE
2	183500000X	Pharmacist	16816	MD

General Provider Information

NPI Number	:	1972851590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. AMAR VENKATA NAGA PADMANABHUNI MS RPH

Provider Business Mailing Address
First Line	:	2714 PHILADELPHIA PIKE
Second Line	:
City	:	CLAYMONT
State	:	DE
Zip	:	19703-2568
Country	:	US
Telephone Number	:	302-791-9899
Fax Number	:	302-319-3449

Provider Business Practice Location Address
First Line	:	2714 PHILADELPHIA PIKE
Second Line	:
City	:	CLAYMONT
State	:	DE
Zip	:	19703-2568
Country	:	US
Telephone Number	:	302-791-9899
Fax Number	:	302-319-3449

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

Provider Enumeration Date	:	08/29/2012
Last Update Date	:	05/19/2016

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