Provider Demographics
NPI:1508179433
Name:TALLURI, RAMA KRISHNA
Entity Type:Individual
Prefix:
First Name:RAMA
Middle Name:KRISHNA
Last Name:TALLURI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 PAOLI PIKE
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-4527
Mailing Address - Country:US
Mailing Address - Phone:610-696-0818
Mailing Address - Fax:610-696-0819
Practice Address - Street 1:927 PAOLI PIKE
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4527
Practice Address - Country:US
Practice Address - Phone:610-696-0818
Practice Address - Fax:610-696-0819
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP438917183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist