Provider Demographics
NPI:1427640135
Name:KOLLU, INDU (PHARMD)
Entity type:Individual
Prefix:DR
First Name:INDU
Middle Name:
Last Name:KOLLU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2119 SIMSBURY LN
Mailing Address - Street 2:
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-6511
Mailing Address - Country:US
Mailing Address - Phone:480-206-7460
Mailing Address - Fax:
Practice Address - Street 1:2119 SIMSBURY LN
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-6511
Practice Address - Country:US
Practice Address - Phone:480-206-7460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH027877183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist