Provider Demographics
NPI:1699073296
Name:CHIGURUPATI, NARENDRA NAIDU
Entity type:Individual
Prefix:MR
First Name:NARENDRA
Middle Name:NAIDU
Last Name:CHIGURUPATI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 E BESSEMER AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-7002
Mailing Address - Country:US
Mailing Address - Phone:910-364-4249
Mailing Address - Fax:
Practice Address - Street 1:920 E BESSEMER AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-7002
Practice Address - Country:US
Practice Address - Phone:910-364-4249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-05
Last Update Date:2012-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18796183500000X
TX47072183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC18796OtherPHARMACIST LICENCE
TX47072OtherPHARMACIST LICENSE NUMBER