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General NPI Number Information
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NPI Number | 1083644819
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Entity Type | Organization
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Legal Business Name | SLV PHARMACY INC
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 05/10/2010
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Provider Practice Location Address
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Address Line | 107 ROUTE 10 EAST
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City | SUCCASUNNA
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State | NJ
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Zip | 07876
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Country | US
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Telephone | 973-584-4200
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Fax | 973-584-7266
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Provider Business Mailing Address
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Address Line | 107 ROUTE 10 EAST
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City | SUCCASUNNA
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State | NJ
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Zip | 07876
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Country | US
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Telephone | 973-584-4200
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Fax | 973-584-7266
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. ANNAPURNA MADDALI
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Credential |
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Telephone | 973-584-4200
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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 | 28RX00558600
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License Number State | NJ
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