Provider Demographics
NPI:1538329339
Name:KASIREDDY, ARAVIND KUMAR REDDY (RPH)
Entity Type:Individual
Prefix:MR
First Name:ARAVIND
Middle Name:KUMAR REDDY
Last Name:KASIREDDY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5024 HICKORY MEADOWS PLACE
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059
Mailing Address - Country:US
Mailing Address - Phone:804-966-2151
Mailing Address - Fax:
Practice Address - Street 1:9100 POCAHONTAS TRAIL
Practice Address - Street 2:
Practice Address - City:PROVIDENCE FORGE
Practice Address - State:VA
Practice Address - Zip Code:23140
Practice Address - Country:US
Practice Address - Phone:804-966-2151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-15
Last Update Date:2017-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0201001207183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0202207729OtherVA BOARD OF PHARMACY