Provider Demographics
NPI:1790263309
Name:POTTI, BHUVANESWARI (PHARM D)
Entity type:Individual
Prefix:
First Name:BHUVANESWARI
Middle Name:
Last Name:POTTI
Suffix:
Gender:
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 SUNDANCE LN
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-4328
Mailing Address - Country:US
Mailing Address - Phone:973-652-1640
Mailing Address - Fax:
Practice Address - Street 1:2404 S PROMENADE BLVD
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-9080
Practice Address - Country:US
Practice Address - Phone:479-986-1101
Practice Address - Fax:479-986-1111
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-06
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03918800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist