Individual provider Active NPI

Pramod Parshaboina

  • Pharmacist
  • Salisbury, MD
National Provider Identifier
1174123822
Registry record updated Oct 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
18919 Issued in MD
Practice address
409 N Fruitland Blvd
Salisbury, MD 21801-7201
Phone
(410) 341-6208
NPI assigned
Oct 30, 2020
Last updated
Oct 30, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 18919 MD Primary

Addresses

Primary practice location

409 N Fruitland Blvd
Salisbury, MD 21801-7201

Mailing address

707 Wye Oak Dr
Fruitland, MD 21826-1929

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

LicenseStateTypeSpecialty
18919MDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1604016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1174123822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 WYE OAK DR",
            "city": "FRUITLAND",
            "state": "MD",
            "postal_code": "218261929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 N FRUITLAND BLVD",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218017201",
            "telephone_number": "410-341-6208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARSHABOINA",
        "first_name": "PRAMOD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-30",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "18919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2020; 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.