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General NPI Number Information
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NPI Number | 1063834430
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Entity Type | Organization
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Legal Business Name | JAI SAI VENKATESWARA PHARMACY LLC
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Dates
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Enumeration Date | 01/20/2014
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Last Update Date | 06/16/2014
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Provider Practice Location Address
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Address Line | 634 FULTON AVE
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City | HEMPSTEAD
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State | NY
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Zip | 11550-4544
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Country | US
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Telephone | 516-565-2300
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Fax | 516-565-2605
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Provider Business Mailing Address
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Address Line | 634 FULTON AVE
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City | HEMPSTEAD
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State | NY
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Zip | 11550-4544
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Country | US
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Telephone | 516-565-2300
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Fax | 516-565-2605
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Authorized Official
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Title or Position | MEMBER
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Name | SRIHARI VUTUKURI
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Credential |
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Telephone | 516-565-2300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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