Venu Gopal Potluri, R.PH

Primary specialty

PharmacistTaxonomy code 183500000X

License

5302036343 Issued in MI

Practice address

1059 E 9 Mile Rd
Hazel Park, MI 48030-1855

Phone

(248) 808-6929

NPI assigned

Sep 24, 2012

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ez RX LLC

  • Community/Retail Pharmacy
  • Hazel Park, MI
  • NPI 1104136605
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1348444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348444800000",
    "number": "1033460563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1856 COOLIDGE HWY",
            "address_2": "APT 209",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843609",
            "telephone_number": "248-792-9501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1059 E 9 MILE RD",
            "city": "HAZEL PARK",
            "state": "MI",
            "postal_code": "480301855",
            "telephone_number": "248-808-6929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTLURI",
        "first_name": "VENU",
        "middle_name": "GOPAL",
        "credential": "R.PH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-24",
        "last_updated": "2012-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302036343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Payne Family Care LLC
• Peaces of You, LLC
• Perry Drug Stores Inc and Subsidiaries
• Phoenix Rehabilitation Service
• Kristen Charlene Ponichter, DMD
• Lashanda Powell
• Primary Medical Urgent Care P.C.
• Prism Park Optical Studio
• Professional Dental Alliance of Michigan, LLC
• Professional Resources Unlimited, Inc.

• Pharmacist in Hazel Park, MI
• Providers in Hazel Park, MI by specialty
• Pharmacist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.