Provider Demographics
NPI:1982984621
Name:REDDY & AFRAM LLC
Entity Type:Organization
Organization Name:REDDY & AFRAM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAJESHWER
Authorized Official - Middle Name:REDDY
Authorized Official - Last Name:PINGILI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-252-5247
Mailing Address - Street 1:1776 YORK RD
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093
Mailing Address - Country:US
Mailing Address - Phone:410-252-5247
Mailing Address - Fax:410-252-5248
Practice Address - Street 1:1776 YORK RD
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093
Practice Address - Country:US
Practice Address - Phone:410-252-5247
Practice Address - Fax:410-252-5248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-25
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD048997200Medicaid