MEDICARE: SVNE PHARMA INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy	PP481216	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2132672	OTHER		PK

General Provider Information

NPI Number	:	1841202231
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SVNE PHARMA INC

Provider Business Mailing Address
First Line	:	1916 WELSH RD
Second Line	:	UNIT 4
City	:	PHILADELPHIA
State	:	PA
Zip	:	19115-4655
Country	:	US
Telephone Number	:	215-464-7600
Fax Number	:	215-464-7601

Provider Business Practice Location Address
First Line	:	1916 WELSH RD
Second Line	:	UNIT 4
City	:	PHILADELPHIA
State	:	PA
Zip	:	19115-4655
Country	:	US
Telephone Number	:	215-464-7600
Fax Number	:	215-464-7601

Authorized Official
Title or Position	:	MANAGER
Name	:	SUNIL GADA
Credential	:
Telephone Number	:	215-464-7600

Provider Enumeration Date	:	08/13/2006
Last Update Date	:	05/12/2015

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Directions to “SVNE PHARMA INC ” Practice Location

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