Individual
MR. GANGADAR GUBBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D
Contact information
Practice address
2720 S QUILLAN STREET, WAL-MART PHARMACY (STORE: 2101), KENNEWICK, WA 99337-9702
(509) 586-1574
(509) 585-1413
Mailing address
2720 S QUILLAN STREET, WAL-MART PHARMACY (STORE: 2101), KENNEWICK, WA 99337-9702
(509) 586-1574
(509) 585-1413
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH60128771
WA
183500000X
Pharmacist
RPH-0012606
OR
Other
Enumeration date
09/07/2016
Last updated
09/07/2016
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