Provider Demographics
NPI:1407379340
Name:RAMACHANDRAN, SUBRAMANIAM
Entity Type:Individual
Prefix:
First Name:SUBRAMANIAM
Middle Name:
Last Name:RAMACHANDRAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3110 OLNEY SANDY SPRING RD
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1408
Mailing Address - Country:US
Mailing Address - Phone:608-556-3938
Mailing Address - Fax:
Practice Address - Street 1:3110 OLNEY SANDY SPRING RD
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1408
Practice Address - Country:US
Practice Address - Phone:301-774-6155
Practice Address - Fax:301-570-7609
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-23
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH61017876183500000X
CA75477183500000X
HI4074183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist