Provider Demographics
NPI:1922862614
Name:SUTHAR, PRAKASH K (RPH)
Entity Type:Individual
Prefix:
First Name:PRAKASH
Middle Name:K
Last Name:SUTHAR
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399 SHOREHAM DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-5169
Mailing Address - Country:US
Mailing Address - Phone:434-770-1512
Mailing Address - Fax:
Practice Address - Street 1:411 PARK AVE STE 200
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-4629
Practice Address - Country:US
Practice Address - Phone:434-792-8281
Practice Address - Fax:434-792-3235
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0008863183500000X
KY019854183500000X
TN0000042977183500000X
VA0202006432183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist