Provider Demographics
NPI:1689386724
Name:THEKDI, SNEHA INDRAVADAN (RPH)
Entity Type:Individual
Prefix:
First Name:SNEHA
Middle Name:INDRAVADAN
Last Name:THEKDI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12713 WYNDHAM WEST DR
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-7086
Mailing Address - Country:US
Mailing Address - Phone:760-401-6715
Mailing Address - Fax:
Practice Address - Street 1:9714 SLIDING HILL RD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-7940
Practice Address - Country:US
Practice Address - Phone:804-537-3005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202210388183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist