Basic Information
| Provider Information | |||||||||
| NPI: | 1801205943 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PUTHUCODE | ||||||||
| FirstName: | RAMANAN | ||||||||
| MiddleName: | NARAYAN | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2801 DUPORTAIL ST | ||||||||
| Address2: | |||||||||
| City: | RICHLAND | ||||||||
| State: | WA | ||||||||
| PostalCode: | 993529107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5096281370 | ||||||||
| FaxNumber: | 5096281541 | ||||||||
| Practice Location | |||||||||
| Address1: | 2801 DUPORTAIL ST | ||||||||
| Address2: | |||||||||
| City: | RICHLAND | ||||||||
| State: | WA | ||||||||
| PostalCode: | 993529107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5096281370 | ||||||||
| FaxNumber: | 5096281541 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/02/2014 | ||||||||
| LastUpdateDate: | 08/02/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | PH00042622 | WA | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.