Active NPI
Sridhar Gudapati
- Pharmacist
- Hagerstown, MD
National Provider Identifier
1790007854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 16834
- Practice address
- 17703 Virginia Ave
Hagerstown, MD 21740-7850 - Phone
- (240) 420-5310
- Fax
- (240) 420-5356
- NPI assigned
- Feb 17, 2010
- Last updated
- Dec 21, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP439420 | PA | |
| Pharmacist | 183500000X | 16834 | MD | Primary |
Addresses
Primary practice location
17703 Virginia Ave
Hagerstown, MD 21740-7850
Mailing address
6075 Fallfish CT
New Market, MD 21774-6742
Phone (718) 791-6004
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
| License | State | Type | Specialty |
|---|---|---|---|
| 16834 | MD | MD | Dentist |
| RP439420 | PA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Columbia Chemists LLC | Past | Accepting new patients |
Organizations & group practices 1
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": "1266364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671580800000",
"number": "1790007854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6075 FALLFISH CT",
"city": "NEW MARKET",
"state": "MD",
"postal_code": "217746742",
"telephone_number": "718-791-6004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17703 VIRGINIA AVE",
"city": "HAGERSTOWN",
"state": "MD",
"postal_code": "217407850",
"telephone_number": "240-420-5310",
"fax_number": "240-420-5356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUDAPATI",
"first_name": "SRIDHAR",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-02-17",
"last_updated": "2022-12-21",
"certification_date": "2022-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP439420",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "16834",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hagerstown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.