Healthcare Provider Details

I. General information

NPI: 1942604376
Provider Name (Legal Business Name): NAVYA HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2014
Last Update Date: 10/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

659 NE US HIGHWAY 19 UNIT 2
CRYSTAL RIVER FL
34429-4240
US

IV. Provider business mailing address

659 NE US HIGHWAY 19 UNIT 2
CRYSTAL RIVER FL
34429-4240
US

V. Phone/Fax

Practice location:
  • Phone: 352-228-8929
  • Fax:
Mailing address:
  • Phone: 352-228-8929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH28629
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License NumberPH28629
License Number StateFL

VIII. Authorized Official

Name: MR. GAURAV MAHATMA
Title or Position: PHARMACY MANAGER
Credential:
Phone: 352-228-8929