Srinivas R Mallidi, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

0202206372 Issued in VA

Practice address

1970 Roanoke Blvd
Salem, VA 24153-6404

Phone

(540) 982-2463

Fax

(540) 224-1970

NPI assigned

Nov 3, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

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

{
    "created_epoch": "1225670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390780800000",
    "number": "1346493384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 ROANOKE BLVD",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241536404",
            "telephone_number": "540-982-2463",
            "fax_number": "540-224-1970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 ROANOKE BLVD",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241536404",
            "telephone_number": "540-982-2463",
            "fax_number": "540-224-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLIDI",
        "first_name": "SRINIVAS",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-03",
        "last_updated": "2014-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202206372",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "13172",
            "primary": false
        },
        {
            "code": "1835N0905X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Nuclear",
            "state": "VA",
            "license": "0202206372",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Maire, DO
• Serene Majid, MD
• Ron Stewart Malachowsky, PA
• Rajinder Singh Malhi, MD
• Farooq Ahmed Malik, MD
• Owori Bwire Mang'Eni
• Christine Anne Mangone, OTR/L
• Julie W Manico, DPT, MSPT
• Caroline E Mann, PHD
• Gloria Polk Manns, LCSW

• Pharmacist in Salem, VA
• Providers in Salem, VA by specialty
• Pharmacist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.