Raghu R Prabhu, RPH

Individual provider Active NPI Pharmacist · Marriottsville, MD

NPI 1194478057 · NPPES record last updated Feb 1, 2022

Key facts

NPI
1194478057
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
11478 (MD)
Practice address
2454 Anderson Hill St
Marriottsville, MD 21104-1491
Phone
(410) 340-0774
NPI assigned
Feb 1, 2022
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
11478MDMDPharmacist
0202214699VAMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202214699 VA
Pharmacist 183500000X 11478 MD Yes

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

Other providers in Marriottsville, MD

All providers in Marriottsville, MD · Pharmacist in Maryland

Sources for this page

Verify at the official NPI Registry.