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Contact Information

S.B.KONDRAGUNTA LLC
34-G MEDICAL PARK BLVD.,
SUITE - G
PETERSBURG, VA23805-9283
 Phone: 804-722-3100
 Fax: 804-722-3120
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Hematology & Oncology

207RH0003X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for S.B.KONDRAGUNTA LLC

NPI Number 1316020399
LBN Legal business name S.B.KONDRAGUNTA LLC
Authorized official BUTCHAIAH KONDRAGUNTA - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/23/2006
Last updated 05/24/2012 - About 14 years ago
Identifiers
VA License # 0101223780
VA Medicaid 5839777
VA Other 258076 BCBS
VA Other 1316020399 NPI
VA Other 110214242 RAIL ROAD
VA Other P00271749 RAIL ROAD
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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