Provider Demographics
NPI:1033528369
Name:SRIVEN PHARMACY LLC
Entity Type:Organization
Organization Name:SRIVEN PHARMACY LLC
Other - Org Name:LAPLATA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JYOTHIRMAI
Authorized Official - Middle Name:
Authorized Official - Last Name:VEERAMARCHNANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-233-2222
Mailing Address - Street 1:6501 CRAIN HWY
Mailing Address - Street 2:
Mailing Address - City:LA PLATA
Mailing Address - State:MD
Mailing Address - Zip Code:20646-4268
Mailing Address - Country:US
Mailing Address - Phone:301-710-6196
Mailing Address - Fax:
Practice Address - Street 1:6501 CRAIN HWY
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-4268
Practice Address - Country:US
Practice Address - Phone:301-710-6196
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy