Organization
SSCP1 LLC
Active
Other names
Medical Arts Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SUDHAKAR VEERANKI (OWNER)
(502) 709-5532
Entity
Organization
Contact information
Practice address
1169 EASTERN PARKWAY, SUITE 1110, LOUISVILLE, KY 40217-1462
(502) 709-5532
(502) 371-6659
Mailing address
1169 EASTERN PARKWAY, SUITE 1110, LOUISVILLE, KY 40217-1462
(502) 709-5532
(502) 371-6659
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2163762
PK
—
05
—
7100536810
—
KY
Enumeration date
01/17/2017
Last updated
01/24/2020
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