Organization
SRI SAI SANVI INTEGRATIVE PHARMACY SERVICES LLC
Active
Other names
Care 1st Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
NAGARAJU TUMMALA (PHARMACY MANAGER/ OWNER / PIC/AO)
(904) 207-0355
Entity
Organization
Contact information
Practice address
1101 BLANDING BLVD STE 122, ORANGE PARK, FL 32065-6751
(904) 644-8038
(904) 644-8671
Mailing address
3515 LAUREL MILL DR, ORANGE PARK, FL 32065-5271
(904) 644-8038
(904) 644-8671
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH29483
FL
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016742100
—
FL
01
—
2157981
PK
—
Enumeration date
02/06/2016
Last updated
02/16/2017
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