Provider Demographics
NPI:1457936049
Name:OM PHARMA LLC
Entity Type:Organization
Organization Name:OM PHARMA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OMPHANIDHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:NADIMPALLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-426-2640
Mailing Address - Street 1:605 S GEORGE ST STE 130
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17401-3161
Mailing Address - Country:US
Mailing Address - Phone:717-747-3586
Mailing Address - Fax:717-747-3642
Practice Address - Street 1:605 S GEORGE ST STE 130
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17401-3161
Practice Address - Country:US
Practice Address - Phone:717-747-3586
Practice Address - Fax:717-747-3642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy