NPIMap

Individual provider Active NPI

Sreenadha Reddy Bommu, RPH

  • Pharmacist
  • Mount Olive, NC
National Provider Identifier
1144638073
Registry record updated Jul 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
20245 Issued in NC
Practice address
308 NC Highway 55 W
Mount Olive, NC 28365-8526
Phone
(919) 658-2608
NPI assigned
Jul 23, 2014
Last updated
Jul 23, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 20245 NC Primary

Addresses

Primary practice location

308 NC Highway 55 W
Mount Olive, NC 28365-8526

Mailing address

308 NC Highway 55 W
Mount Olive, NC 28365-8526
Phone (919) 658-2608

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
20245NCMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ask RX Inc Current Accepting new patients
Wal-Mart Stores East LP Past Accepting new patients
Wal-Mart Stores East, LP Past Accepting new patients

Organizations & group practices 3

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": "1406073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406073600000",
    "number": "1144638073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 NC HIGHWAY 55 W",
            "city": "MOUNT OLIVE",
            "state": "NC",
            "postal_code": "283658526",
            "telephone_number": "919-658-2608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 NC HIGHWAY 55 W",
            "city": "MOUNT OLIVE",
            "state": "NC",
            "postal_code": "283658526",
            "telephone_number": "919-658-2608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMMU",
        "first_name": "SREENADHA REDDY",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-23",
        "last_updated": "2014-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "20245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Olive, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2014; 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.