Provider Demographics
NPI:1821350703
Name:BANDI, VENU (BPHARM)
Entity Type:Individual
Prefix:
First Name:VENU
Middle Name:
Last Name:BANDI
Suffix:
Gender:M
Credentials:BPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1393 E SARAGOSA ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-2095
Mailing Address - Country:US
Mailing Address - Phone:925-663-9469
Mailing Address - Fax:
Practice Address - Street 1:1393 E SARAGOSA ST
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-2095
Practice Address - Country:US
Practice Address - Phone:925-663-9469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-15
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48552183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist