Provider Demographics
NPI:1558468470
Name:SVA PHARMACY CORP
Entity Type:Organization
Organization Name:SVA PHARMACY CORP
Other - Org Name:TRIANGLE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NAVJOT
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:BAL
Authorized Official - Suffix:
Authorized Official - Credentials:PHAMD
Authorized Official - Phone:718-847-9850
Mailing Address - Street 1:119-01 JAMAICA AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418
Mailing Address - Country:US
Mailing Address - Phone:718-847-9850
Mailing Address - Fax:718-847-9851
Practice Address - Street 1:119-01 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418
Practice Address - Country:US
Practice Address - Phone:718-847-9850
Practice Address - Fax:718-847-9851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0271983336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02646817Medicaid
2059353OtherPK
2059353OtherPK