Provider Demographics
NPI:1912237108
Name:A-DR REDDY PHARMACY
Entity Type:Organization
Organization Name:A-DR REDDY PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:SWAPNA
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:RHP
Authorized Official - Phone:760-881-0417
Mailing Address - Street 1:12998 HESPERIA RD
Mailing Address - Street 2:STE 102
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-8316
Mailing Address - Country:US
Mailing Address - Phone:760-948-3058
Mailing Address - Fax:
Practice Address - Street 1:12998 HESPERIA RD
Practice Address - Street 2:STE 102
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-8316
Practice Address - Country:US
Practice Address - Phone:760-948-3058
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-11
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA501803336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy