Provider Demographics
NPI:1780929778
Name:PIDIKITI, RAMAKRISHNA V (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:RAMAKRISHNA
Middle Name:V
Last Name:PIDIKITI
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11901 176TH ST APT 141
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90701-4043
Mailing Address - Country:US
Mailing Address - Phone:562-292-7041
Mailing Address - Fax:
Practice Address - Street 1:11901 176TH ST APT 141
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:CA
Practice Address - Zip Code:90701-4043
Practice Address - Country:US
Practice Address - Phone:562-292-7041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-03
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA66821183500000X
NV18012183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist