Healthcare Provider Details

I. General information

NPI: 1114844974
Provider Name (Legal Business Name): SRAVYA NIMMAGADDA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 VIRGINIA AVE
INDIANAPOLIS IN
46204-3709
US

IV. Provider business mailing address

218 PEOPLES WAY
HOCKESSIN DE
19707-1904
US

V. Phone/Fax

Practice location:
  • Phone: 833-401-1577
  • Fax:
Mailing address:
  • Phone: 302-690-6423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberA1-0005021
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: