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NPI Code Detail

MEDICARE: SSV PHARMACY 1 LLC

MEDICARE: SSV PHARMACY 1 LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies
23336L0003XLong Term Care Pharmacy
33336S0011XSpecialty Pharmacy
43336C0003XCommunity/Retail Pharmacy

General Provider Information

NPI Number : 1265098719
Entity Type Code : Organization
Provider Name (Legal Business Name) : SSV PHARMACY 1 LLC
Provider Business Mailing Address
First Line : 500 FARMINGTON AVE
Second Line :
City : HARTFORD
State : CT
Zip : 06105-3106
Country : US
Telephone Number : 860-522-9289
Fax Number : 860-231-7007
Provider Business Practice Location Address
First Line : 500 FARMINGTON AVE
Second Line :
City : HARTFORD
State : CT
Zip : 06105-3106
Country : US
Telephone Number : 860-522-9289
Fax Number : 860-231-7007
Authorized Official
Title or Position : MEMBER
Name : MISS SANDHYA R KANTAMANENI
Credential :
Telephone Number : 860-522-9289
Provider Enumeration Date : 05/09/2019
Last Update Date : 05/09/2019

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Directions to “SSV PHARMACY 1 LLC ” Practice Location

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