Provider Demographics
NPI:1689905374
Name:PILLAI, SUDHA A (PHARMACIST)
Entity Type:Individual
Prefix:MRS
First Name:SUDHA
Middle Name:A
Last Name:PILLAI
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5363 N SABINO CANYON RD APT 17
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-7090
Mailing Address - Country:US
Mailing Address - Phone:520-326-5868
Mailing Address - Fax:
Practice Address - Street 1:3180 N CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-2302
Practice Address - Country:US
Practice Address - Phone:520-326-5868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS16426183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist