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General NPI Number Information
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NPI Number | 1033529607
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Entity Type | Organization
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Legal Business Name | SSII PHARMA LLC
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Dates
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Enumeration Date | 05/05/2014
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Last Update Date | 09/12/2016
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Provider Practice Location Address
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Address Line | 1502 S 7TH ST
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City | LOUISVILLE
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State | KY
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Zip | 40208-1711
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Country | US
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Telephone | 502-912-8966
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Fax | 502-371-5439
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Provider Business Mailing Address
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Address Line | 1502 S 7TH ST
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City | LOUISVILLE
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State | KY
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Zip | 40208-1711
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Country | US
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Telephone | 502-912-8966
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Fax | 502-371-5439
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Authorized Official
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Title or Position | MANAGER
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Name | SUJATHA VEERANKI
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Credential |
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Telephone | 502-912-8966
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | P07797
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License Number State | KY
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