Healthcare Provider Details

I. General information

NPI: 1619954443
Provider Name (Legal Business Name): SV PHARMA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 02/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 OCEAN AVE
JERSEY CITY NJ
07305-2613
US

IV. Provider business mailing address

227 OCEAN AVE
JERSEY CITY NJ
07305-2613
US

V. Phone/Fax

Practice location:
  • Phone: 201-433-1512
  • Fax: 201-433-1566
Mailing address:
  • Phone: 201-433-1512
  • Fax: 201-433-1566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number28RS00017400
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SUDHEER MALGIREDDY
Title or Position: PHARMACIST IN CHARGE
Credential:
Phone: 201-433-1512