Healthcare Provider Details

I. General information

NPI: 1609969971
Provider Name (Legal Business Name): OMSHREE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2006
Last Update Date: 07/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 SE FRONT ST
MILFORD DE
19963-1942
US

IV. Provider business mailing address

10 SE FRONT ST
MILFORD DE
19963
US

V. Phone/Fax

Practice location:
  • Phone: 302-265-2756
  • Fax: 302-491-6235
Mailing address:
  • Phone: 302-265-2756
  • Fax: 302-491-6235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1699969971
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number830000836
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number830000836
License Number StateDE

VIII. Authorized Official

Name: TEJAS SHETH
Title or Position: PHARMACY MANAGER
Credential: RPH
Phone: 302-265-2756