Active NPI
Hariharaprasad Rao Redyshetty, RPH
- Pharmacist
- Lake Orion, MI
National Provider Identifier
1700160967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302036344
- Practice address
- 450 N Park Blvd
Lake Orion, MI 48362-3152 - Phone
- (248) 814-7315
- Fax
- (278) 814-7364
- NPI assigned
- Oct 6, 2011
- Last updated
- Oct 6, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302036344 | MI | Primary |
Addresses
Primary practice location
450 N Park Blvd
Lake Orion, MI 48362-3152
Mailing address
2445 Andover Blvd
Rochester Hills, MI 48306-4937
Phone (248) 275-5635
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302036344 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317859200000",
"number": "1700160967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2445 ANDOVER BLVD",
"city": "ROCHESTER HILLS",
"state": "MI",
"postal_code": "483064937",
"telephone_number": "248-275-5635"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 N PARK BLVD",
"city": "LAKE ORION",
"state": "MI",
"postal_code": "483623152",
"telephone_number": "248-814-7315",
"fax_number": "278-814-7364"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDYSHETTY",
"first_name": "HARIHARAPRASAD",
"middle_name": "RAO",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-10-06",
"last_updated": "2011-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302036344",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Orion, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.