Provider Demographics
NPI:1780275685
Name:SRI GANESH PHARMACY SERVICES LLC
Entity type:Organization
Organization Name:SRI GANESH PHARMACY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:TEJAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SHETH
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:302-519-6847
Mailing Address - Street 1:10121 FAST COLORS LN
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:MD
Mailing Address - Zip Code:21811-1501
Mailing Address - Country:US
Mailing Address - Phone:410-775-8195
Mailing Address - Fax:
Practice Address - Street 1:500 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:MD
Practice Address - Zip Code:21811-1337
Practice Address - Country:US
Practice Address - Phone:410-775-8195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy