Healthcare Provider Details

I. General information

NPI: 1629597646
Provider Name (Legal Business Name): SAANVI GROUP OF PENNSYLVANIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2017
Last Update Date: 12/16/2020
Certification Date: 12/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 W TILGHMAN ST STE 200
ALLENTOWN PA
18104-9101
US

IV. Provider business mailing address

5000 W TILGHMAN ST STE 200
ALLENTOWN PA
18104-9101
US

V. Phone/Fax

Practice location:
  • Phone: 610-266-3999
  • Fax: 310-266-3399
Mailing address:
  • Phone: 610-266-3999
  • Fax: 310-266-3399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number04950501
License Number StatePA

VIII. Authorized Official

Name: HARISHANTHAN NAGIREDDY
Title or Position: MEMBER/OWNER
Credential:
Phone: 317-652-1584