Active NPI
Raghu R Prabhu, RPH
- Pharmacist
- Marriottsville, MD
National Provider Identifier
1194478057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11478
- Practice address
- 2454 Anderson Hill St
Marriottsville, MD 21104-1491 - Phone
- (410) 340-0774
- NPI assigned
- Feb 1, 2022
- Last updated
- Feb 1, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202214699 | VA | |
| Pharmacist | 183500000X | 11478 | MD | Primary |
Addresses
Primary practice location
2454 Anderson Hill St
Marriottsville, MD 21104-1491
Mailing address
2454 Anderson Hill St
Marriottsville, MD 21104-1491
Phone (410) 340-0774
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11478 | MD | MD | Pharmacist |
| 0202214699 | VA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643673600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643673600000",
"number": "1194478057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2454 ANDERSON HILL ST",
"city": "MARRIOTTSVILLE",
"state": "MD",
"postal_code": "211041491",
"telephone_number": "410-340-0774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2454 ANDERSON HILL ST",
"city": "MARRIOTTSVILLE",
"state": "MD",
"postal_code": "211041491",
"telephone_number": "410-340-0774"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRABHU",
"first_name": "RAGHU",
"middle_name": "R",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-02-01",
"last_updated": "2022-02-01",
"certification_date": "2022-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202214699",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "11478",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marriottsville, MD
- Moon Healing Acupuncture & Integrative Health LLC
- Ghania Naeem, PHARM.D.
- Next Step Therapy, LLC
- NP Consultant, LLC
- Hakim Ogunsanya, CRNP
- Privia Medical Group, LLC
- Privia Medical Group, LLC
- Hannah Prochaska
- Progressive Physical Therapy, LLC (Phoenix Rehabilitation and Health Services, LLC)
- Progressive Physical Therapy, LLC (Phoenix Rehabilitation and Health Services, LLC)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.