Provider Demographics
NPI:1851826341
Name:RD TANYA & VED LLC
Entity Type:Organization
Organization Name:RD TANYA & VED LLC
Other - Org Name:HEALTHAID PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIVYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BALUMURI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-941-8020
Mailing Address - Street 1:HEALTHAID PHARMACY
Mailing Address - Street 2:6604 FRANKFORD AVE
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19135-2509
Mailing Address - Country:US
Mailing Address - Phone:215-941-8020
Mailing Address - Fax:
Practice Address - Street 1:HEALTHAID PHARMACY
Practice Address - Street 2:6604 FRANKFORD AVE
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19135-2509
Practice Address - Country:US
Practice Address - Phone:215-941-8020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-22
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP4827173336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPP482717OtherSTATE PHARMACY LICENSE