Provider Demographics
NPI:1427426196
Name:SAVANNAH PHARMACY
Entity type:Organization
Organization Name:SAVANNAH PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:MADHURI
Authorized Official - Middle Name:
Authorized Official - Last Name:VEMURI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:940-366-8380
Mailing Address - Street 1:1153 FOSSIL LAKE DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-3939
Mailing Address - Country:US
Mailing Address - Phone:940-366-8380
Mailing Address - Fax:940-366-8381
Practice Address - Street 1:26795 US HIGHWAY 380 E
Practice Address - Street 2:SUITE800
Practice Address - City:AUBREY
Practice Address - State:TX
Practice Address - Zip Code:76227-7853
Practice Address - Country:US
Practice Address - Phone:940-366-8380
Practice Address - Fax:940-366-8381
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SKANDHA PHARMACY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-09-10
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX302003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy