Provider Demographics
NPI:1487661591
Name:SNI HEALTHCARE TECHNOLOGIES, LLC
Entity Type:Organization
Organization Name:SNI HEALTHCARE TECHNOLOGIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:BRYANT
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSHANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-910-1500
Mailing Address - Street 1:13111 COLLECTION CENTER DR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60693-0131
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:700 BUSINESS CENTER DR
Practice Address - Street 2:SUITE 100D
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-3456
Practice Address - Country:US
Practice Address - Phone:267-532-1661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA3000008031332B00000X
PAPP414715L333600000X
DEA9-0000656333600000X
SC60009067333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1015571330001Medicaid
PA3966441OtherNCPDP
PA3966441OtherNCPDP
PA5596820001Medicare NSC