Praveen Potluri, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

58219 Issued in CA

Practice address

3317 W Ramsey St
Banning, CA 92220-3503

Phone

(951) 849-8614

Fax

(951) 849-2057

NPI assigned

May 19, 2008

Last updated

May 19, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

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

• Thrifty Payless Inc

  dba Rite Aid Pharmacy 06833

  • Community/Retail Pharmacy
  • Winchester, CA
  • NPI 1437874062
  NPD (past)

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211155200000",
    "number": "1619134665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1699 E WASHINGTON ST APT 2276",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923246454",
            "telephone_number": "626-242-6880",
            "fax_number": "951-849-8614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3317 W RAMSEY ST",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922203503",
            "telephone_number": "951-849-8614",
            "fax_number": "951-849-2057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTLURI",
        "first_name": "PRAVEEN",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-19",
        "last_updated": "2008-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "58219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ricardo J Pineda, MFT
• Pinnacle Medical Group, Inc.
• Plan-It Life, Inc.
• Natasha Stephanie Plantak, PA
• Jennifer Louise Ponder- Peters
• Lauren Nichole Pounds
• Ryan Provencher
• Providence Hospice Inc
• Henry Pulido
• Desray Putnam

• Pharmacist in Banning, CA
• Providers in Banning, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; 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.