Provider Demographics
NPI:1497702997
Name:SRI VENKATA INC
Entity Type:Organization
Organization Name:SRI VENKATA INC
Other - Org Name:CAREPOINT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MANOJ
Authorized Official - Middle Name:
Authorized Official - Last Name:MANDA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:718-915-4978
Mailing Address - Street 1:10 PLAINFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-4077
Mailing Address - Country:US
Mailing Address - Phone:732-885-1000
Mailing Address - Fax:732-980-0357
Practice Address - Street 1:10 PLAINFIELD AVE
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-4077
Practice Address - Country:US
Practice Address - Phone:732-885-1000
Practice Address - Fax:732-980-0357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2020-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NJ28RS006622003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2057412OtherPK
NJ8399506Medicaid
2057412OtherPK