Healthcare Provider Details

I. General information

NPI: 1073149514
Provider Name (Legal Business Name): SHRI HARI RX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2020
Last Update Date: 03/17/2020
Certification Date: 03/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2079 COMPTON AVE STE 105
CORONA CA
92881-3312
US

IV. Provider business mailing address

15823 AVIATION CT
CHINO CA
91708-7617
US

V. Phone/Fax

Practice location:
  • Phone: 951-365-3434
  • Fax: 951-905-1609
Mailing address:
  • Phone: 951-365-3434
  • Fax: 951-905-1609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. TAPAN RAMESHCHANDRA PATEL
Title or Position: CFO
Credential: PHARM D
Phone: 513-442-8078