Provider Demographics
NPI:1386490340
Name:UPADHYAY, LOKENDRA PRASAD (PHARMD, MBA, RPH)
Entity type:Individual
Prefix:DR
First Name:LOKENDRA
Middle Name:PRASAD
Last Name:UPADHYAY
Suffix:
Gender:M
Credentials:PHARMD, MBA, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 MATHESON WAY
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-6346
Mailing Address - Country:US
Mailing Address - Phone:678-315-9724
Mailing Address - Fax:
Practice Address - Street 1:363 BLUE RIDGE ST
Practice Address - Street 2:
Practice Address - City:BLAIRSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30512-3574
Practice Address - Country:US
Practice Address - Phone:170-674-5695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA22765183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist