Provider Demographics
NPI:1376832287
Name:DOULE, SUDHAKAR (BPHARM)
Entity Type:Individual
Prefix:MR
First Name:SUDHAKAR
Middle Name:
Last Name:DOULE
Suffix:
Gender:M
Credentials:BPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 N BLACKSTONE AVE
Mailing Address - Street 2:RITE AID 05862
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93703
Mailing Address - Country:US
Mailing Address - Phone:559-445-0694
Mailing Address - Fax:559-445-1480
Practice Address - Street 1:1210 N BLACKSTONE AVE
Practice Address - Street 2:RITE AID 05862
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93703
Practice Address - Country:US
Practice Address - Phone:559-445-0694
Practice Address - Fax:559-445-1480
Is Sole Proprietor?:No
Enumeration Date:2011-03-31
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64030183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist