Organization
SHIVA OM LLC
Active
Organization
SHIVA OM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHEFALI SHAH (DIRECTOR)
(215) 437-7573
Entity
Organization
Contact information
Practice address
919 TYSON AVE, PHILADELPHIA, PA 19111-4405
(215) 437-7573
(215) 613-7926
Mailing address
919 TYSON AVE, PHILADELPHIA, PA 19111
(215) 437-7573
(215) 613-7926
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
02/15/2013
Last updated
12/06/2018
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