Provider Demographics
NPI:1851035356
Name:SRAVANTHI KIRAN JOGINIPELLI HEALTH CARE ,LLC
Entity Type:Organization
Organization Name:SRAVANTHI KIRAN JOGINIPELLI HEALTH CARE ,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SRAVANTHI
Authorized Official - Middle Name:
Authorized Official - Last Name:JOGINIPELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-477-6172
Mailing Address - Street 1:365 ALPHA ST
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:AR
Mailing Address - Zip Code:71701-3000
Mailing Address - Country:US
Mailing Address - Phone:703-477-6172
Mailing Address - Fax:
Practice Address - Street 1:365 ALPHA ST
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:AR
Practice Address - Zip Code:71701-3000
Practice Address - Country:US
Practice Address - Phone:703-477-6172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-21
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility