Healthcare Provider Details

I. General information

NPI: 1669176970
Provider Name (Legal Business Name): THE AUSADHA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 06/11/2024
Certification Date: 06/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18474 N US HIGHWAY 41
LUTZ FL
33549-4469
US

IV. Provider business mailing address

18474 N US HIGHWAY 41
LUTZ FL
33549-4469
US

V. Phone/Fax

Practice location:
  • Phone: 813-304-4340
  • Fax:
Mailing address:
  • Phone: 813-949-3200
  • Fax: 813-949-3205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. ARUN SAHU
Title or Position: PHARMACIST
Credential: RPH
Phone: 813-949-3200