Provider Demographics
NPI:1962009969
Name:PRATHIPATI, SREE (PHARMD)
Entity Type:Individual
Prefix:
First Name:SREE
Middle Name:
Last Name:PRATHIPATI
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 1:3777 S ARIZONA AVE
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-2700
Mailing Address - Country:US
Mailing Address - Phone:480-612-6102
Mailing Address - Fax:
Practice Address - Street 1:3777 S ARIZONA AVE
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85248-2700
Practice Address - Country:US
Practice Address - Phone:480-612-6102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-03
Last Update Date:2020-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS024675183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist