Provider Demographics
NPI:1538468319
Name:BUDDINENI, LAXMI NARASIMHA RAO (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:LAXMI NARASIMHA RAO
Middle Name:
Last Name:BUDDINENI
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 CUMBERLAND PKWY
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-5674
Mailing Address - Country:US
Mailing Address - Phone:717-796-7685
Mailing Address - Fax:717-790-9491
Practice Address - Street 1:330 CUMBERLAND PKWY
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-5674
Practice Address - Country:US
Practice Address - Phone:717-796-7685
Practice Address - Fax:717-790-9491
Is Sole Proprietor?:No
Enumeration Date:2011-03-20
Last Update Date:2011-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP439012183500000X
MD16902183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist