Provider Demographics
NPI:1639476096
Name:JANNAPALLY, SURESH R (RPH)
Entity type:Individual
Prefix:MR
First Name:SURESH
Middle Name:R
Last Name:JANNAPALLY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 WAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910
Mailing Address - Country:US
Mailing Address - Phone:301-562-5414
Mailing Address - Fax:
Practice Address - Street 1:825 WAYNE AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910
Practice Address - Country:US
Practice Address - Phone:301-562-5414
Practice Address - Fax:301-490-8244
Is Sole Proprietor?:No
Enumeration Date:2011-02-22
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3604183500000X
NY055323183500000X, 183500000X
MD19034183500000X
DEA1-0004012183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist