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General NPI Number Information
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NPI Number | 1164575296
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Entity Type | Organization
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Legal Business Name | SRI SATYA SAI INC
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Dates
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Enumeration Date | 01/20/2007
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Last Update Date | 09/17/2010
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Provider Practice Location Address
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Address Line | 533 HAMILTON AVE
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City | TRENTON
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State | NJ
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Zip | 08609-2625
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Country | US
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Telephone | 609-393-1776
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Fax | 609-393-4426
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Provider Business Mailing Address
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Address Line | 533 HAMILTON AVE
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City | TRENTON
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State | NJ
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Zip | 08609-2625
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Country | US
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Telephone | 609-393-1776
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Fax | 609-393-4426
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Authorized Official
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Title or Position | PHARMACIST
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Name | MR. RAGHUNATH REDDY BHAVANAM
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Credential | B.PHARMACY
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Telephone | 609-393-1775
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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 | 28RS00650400
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License Number State | NJ
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