Provider Demographics
NPI:1588224729
Name:PAMULAPATI, LAUREN G (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:G
Last Name:PAMULAPATI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 N 12TH STREET
Mailing Address - Street 2:P.O. BOX 980533
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298
Mailing Address - Country:US
Mailing Address - Phone:804-828-9199
Mailing Address - Fax:
Practice Address - Street 1:4730 N SOUTHSIDE PLAZA ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23224-1742
Practice Address - Country:US
Practice Address - Phone:804-230-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02022140171835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care