Provider Demographics
NPI:1053484774
Name:KPR PHARMACEUTICALS INC
Entity Type:Organization
Organization Name:KPR PHARMACEUTICALS INC
Other - Org Name:SMARTMED PRESCRIPTION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAMASWAMY
Authorized Official - Middle Name:
Authorized Official - Last Name:GUMMADI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-243-9100
Mailing Address - Street 1:233 E HIGH ST
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-2521
Mailing Address - Country:US
Mailing Address - Phone:717-243-9100
Mailing Address - Fax:717-243-8732
Practice Address - Street 1:233 E HIGH ST
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-2521
Practice Address - Country:US
Practice Address - Phone:717-243-9100
Practice Address - Fax:717-243-8732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
PAPP414966L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2124530OtherPK
PA1024678720001Medicaid
PA1024678720001Medicaid