Individual
KISHORI KOPPU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
278 OAK ST, SHREWSBURY, MA 01545-4332
(774) 534-8296
Mailing address
278 OAK ST, SHREWSBURY, MA 01545-4332
(774) 534-8296
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
PH239171
MA
183500000X
Pharmacist
Primary
RP454022
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
N/A
—
Enumeration date
10/25/2019
Last updated
10/25/2019
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