Individual provider Active NPI

Sonu Koul Raina

  • Pharmacist
  • Kennesaw, GA
National Provider Identifier
1598063109
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH021986 Issued in GA
Practice address
4360 Bells Ferry Rd NW
Kennesaw, GA 30144-1354
Phone
(678) 445-5064
NPI assigned
Mar 5, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH021986 GA Primary

Addresses

Primary practice location

4360 Bells Ferry Rd NW
Kennesaw, GA 30144-1354

Mailing address

1055 Bagwell Dr NW
Kennesaw, GA 30152-7834
Phone (770) 420-8849

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
RPH021986GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co PastSince Dec 28, 2022 Accepting new patients
Walgreen Co PastSince Dec 28, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1299283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1598063109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 BAGWELL DR NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301527834",
            "telephone_number": "770-420-8849",
            "fax_number": "678-574-9425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4360 BELLS FERRY RD NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301441354",
            "telephone_number": "678-445-5064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUL RAINA",
        "first_name": "SONU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-05",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH021986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.

Verify at the official NPI Registry.