Healthcare Provider Details

I. General information

NPI: 1639101249
Provider Name (Legal Business Name): SAI PHARMA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 08/30/2023
Certification Date: 08/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2112 BEL AIR RD STE 11
FALLSTON MD
21047-2786
US

IV. Provider business mailing address

2112 BEL AIR RD STE 11
FALLSTON MD
21047-2786
US

V. Phone/Fax

Practice location:
  • Phone: 410-879-9000
  • Fax: 410-879-9047
Mailing address:
  • Phone: 410-879-9000
  • Fax: 410-879-9047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP06245
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: NAVEEN KUNAPARAJU
Title or Position: OWNER
Credential:
Phone: 410-879-9000