Active NPI
Surya N Vangapandu
- Pharmacist
- Marietta, GA
National Provider Identifier
1033438676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH023975
- Practice address
- 23 S Marietta Pkwy SW
Marietta, GA 30064-3288 - Phone
- (770) 420-8932
- NPI assigned
- May 21, 2010
- Last updated
- May 21, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH023975 | GA | Primary |
Addresses
Primary practice location
23 S Marietta Pkwy SW
Marietta, GA 30064-3288
Mailing address
11980 Fox Rd
Alpharetta, GA 30005-7526
Phone (770) 442-3337
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH023975 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nba Pharmacy LLC | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274400000000",
"number": "1033438676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11980 FOX RD",
"city": "ALPHARETTA",
"state": "GA",
"postal_code": "300057526",
"telephone_number": "770-442-3337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23 S MARIETTA PKWY SW",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300643288",
"telephone_number": "770-420-8932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANGAPANDU",
"first_name": "SURYA",
"middle_name": "N",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-05-21",
"last_updated": "2010-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH023975",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.