Provider Demographics
NPI:1417256249
Name:SURAPANENI, SUNITA
Entity Type:Individual
Prefix:
First Name:SUNITA
Middle Name:
Last Name:SURAPANENI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 NW MAYNARD RD
Mailing Address - Street 2:RITEAID PHARMACY
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513
Mailing Address - Country:US
Mailing Address - Phone:919-469-6087
Mailing Address - Fax:919-467-3747
Practice Address - Street 1:1200 NW MAYNARD RD
Practice Address - Street 2:RITEAID PHARMACY
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513
Practice Address - Country:US
Practice Address - Phone:919-469-6087
Practice Address - Fax:919-467-3747
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19489183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist