Organization
JAI JAGANNATH INC
Active
Other names
SUNNYVALE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SRINIVASA RAO KOMIRISETTY (PRESIDENT)
(972) 290-0341
Entity
Organization
Contact information
Practice address
3635 N BELT LINE RD STE 100, SUNNYVALE, TX 75182-9235
(972) 290-0341
(972) 290-0351
Mailing address
3635 N BELT LINE RD STE 100, SUNNYVALE, TX 75182-9235
(972) 290-0341
(972) 290-0351
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
31851
TX
Other
Enumeration date
02/12/2018
Last updated
02/12/2018
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