Healthcare Provider Details

I. General information

NPI: 1043517949
Provider Name (Legal Business Name): ISHAAN AND RIHAAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2011
Last Update Date: 08/26/2021
Certification Date: 08/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 E BAY DR STE E
LARGO FL
33771-1004
US

IV. Provider business mailing address

1300 E BAY DR STE E
LARGO FL
33771-1004
US

V. Phone/Fax

Practice location:
  • Phone: 727-767-9550
  • Fax: 727-767-9505
Mailing address:
  • Phone: 727-767-9550
  • Fax: 727-767-9505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPH25224
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MRS. AILENE SALSGIVER
Title or Position: MEMBER
Credential:
Phone: 727-460-7730