Sirisansh LLC

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

SIRISANSH LLC

Practice address

3838 Sherman Dr.
Ste. 1
Riverside, CA 92503

Phone

(951) 687-4203

Fax

(909) 687-1145

NPI assigned

Jun 23, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sirisha Palavalli

Title

Manager Member

Phone

(951) 687-4203

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• Parke Vista Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chandrasekhar Eadara

  • Pharmacist
  • Riverside, CA
  • NPI 1053855585
  NPD (past)
• Raana Sidky

  • Pharmacist
  • Riverside, CA
  • NPI 1891107850
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710115200000",
    "number": "1063448280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3838 SHERMAN DR.",
            "address_2": "STE. 1",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92503",
            "telephone_number": "951-687-4203",
            "fax_number": "909-687-1145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 SHERMAN DR.",
            "address_2": "STE. 1",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92503",
            "telephone_number": "951-687-4203",
            "fax_number": "909-687-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIRISANSH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2024-03-11",
        "status": "A",
        "authorized_official_last_name": "PALAVALLI",
        "authorized_official_first_name": "SIRISHA",
        "authorized_official_title_or_position": "MANAGER MEMBER",
        "authorized_official_telephone_number": "951-687-4203"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "55696",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA420140",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1995845",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Parke Vista Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ashish C Sinha, MD
• Mallavi Shanker Sinha
• Sachchida N. Sinha, M.D.
• Elaine P Sio
• Gina Maria Sirimarco, CADCII,
• Shern Sirisuk, DO
• Brian Sirko
• Robert I Sirotnik, D.D.S.
• Clarence A Sisnett Jr., PHARMD
• Allen Sison

• Pharmacy in Riverside, CA
• Providers in Riverside, CA by specialty
• Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.