Provider Demographics
NPI:1316790173
Name:S4 PHARMACY INC
Entity type:Organization
Organization Name:S4 PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHALINI
Authorized Official - Middle Name:
Authorized Official - Last Name:MUPPALANENI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:408-929-2210
Mailing Address - Street 1:3130 ALUM ROCK AVE STE A
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95127-2901
Mailing Address - Country:US
Mailing Address - Phone:408-393-6938
Mailing Address - Fax:
Practice Address - Street 1:3130 ALUM ROCK AVE STE A
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95127-2901
Practice Address - Country:US
Practice Address - Phone:408-929-2210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:S4 PHARMACY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy