Provider Demographics
NPI:1831219336
Name:JANNU, CHIRANJIVI BHARATH (RPH, C,PH)
Entity type:Individual
Prefix:MR
First Name:CHIRANJIVI
Middle Name:BHARATH
Last Name:JANNU
Suffix:
Gender:M
Credentials:RPH, C,PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1592 ROUTE 739
Mailing Address - Street 2:
Mailing Address - City:DINGMANS FERRY
Mailing Address - State:PA
Mailing Address - Zip Code:18328-3513
Mailing Address - Country:US
Mailing Address - Phone:646-673-0044
Mailing Address - Fax:
Practice Address - Street 1:3940 W HILLSBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-5628
Practice Address - Country:US
Practice Address - Phone:813-874-2900
Practice Address - Fax:813-874-2909
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPSI17968183500000X
PARP443524183500000X
FLPU7063183500000X
FLPS43238183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist