Provider Demographics
NPI:1053781302
Name:ANNAPUREDDY, ANUSHA
Entity type:Individual
Prefix:
First Name:ANUSHA
Middle Name:
Last Name:ANNAPUREDDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5668 MAGNOLIA RUN CIR
Mailing Address - Street 2:APT 101
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-1576
Mailing Address - Country:US
Mailing Address - Phone:413-552-9698
Mailing Address - Fax:
Practice Address - Street 1:4245 HOLLAND RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1904
Practice Address - Country:US
Practice Address - Phone:757-474-2386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-30
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202214278183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist