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
| License | State | Type | Specialty |
|---|---|---|---|
| 11478 | MD | MD | Pharmacist |
| 0202214699 | VA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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All providers in Marriottsville, MD · Pharmacist in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.