Healthcare Provider Details

I. General information

NPI: 1730357625
Provider Name (Legal Business Name): NNR GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2008
Last Update Date: 12/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7535 MEDICAL DR STE 1
HUDSON FL
34667-6502
US

IV. Provider business mailing address

7535 MEDICAL DR STE 1
HUDSON FL
34667-6502
US

V. Phone/Fax

Practice location:
  • Phone: 727-869-3784
  • Fax: 727-869-3783
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH23177
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: NARESH JAIN
Title or Position: PHCY MANG
Credential:
Phone: 727-267-9131