Provider Demographics
NPI:1952920076
Name:KUMUD S TRIPATHY AND ASSOCIATES
Entity Type:Organization
Organization Name:KUMUD S TRIPATHY AND ASSOCIATES
Other - Org Name:CANCER CLINIC PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:979-977-0193
Mailing Address - Street 1:2215 E VILLA MARIA RD STE 120
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-2585
Mailing Address - Country:US
Mailing Address - Phone:979-977-0193
Mailing Address - Fax:979-776-0427
Practice Address - Street 1:2215 E VILLA MARIA RD STE 120
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-2585
Practice Address - Country:US
Practice Address - Phone:979-977-0193
Practice Address - Fax:979-776-0427
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KUMUD S TRIPATHY AND ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-09
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy