Provider Demographics
NPI:1063591238
Name:SVM3 PHARMA INC
Entity type:Organization
Organization Name:SVM3 PHARMA INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:RAVI KIRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NALLA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:717-485-3724
Mailing Address - Street 1:182 BUCHANAN TRL
Mailing Address - Street 2:SUITE: 150
Mailing Address - City:MC CONNELLSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17233-8261
Mailing Address - Country:US
Mailing Address - Phone:717-485-3724
Mailing Address - Fax:717-485-5924
Practice Address - Street 1:182 BUCHANAN TRAIL,
Practice Address - Street 2:SUITE: 150
Practice Address - City:MCCONNELLSBURG
Practice Address - State:PA
Practice Address - Zip Code:17233
Practice Address - Country:US
Practice Address - Phone:717-485-3724
Practice Address - Fax:717-485-5924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
PAPP411532L333600000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1029327200001Medicaid
2080085OtherPK
2080085OtherPK
PA987280Medicaid