Healthcare Provider Details
I. General information
NPI: 1841962958
Provider Name (Legal Business Name): VISHNUH LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/28/2021
Last Update Date: 09/28/2021
Certification Date: 09/07/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10475 COUNTY LINE RD
SPRING HILL FL
34609-5695
US
IV. Provider business mailing address
PO BOX 1930
LUTZ FL
33548-1930
US
V. Phone/Fax
- Phone: 352-600-6699
- Fax: 352-600-6690
- Phone: 352-600-6699
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336S0011X |
| Taxonomy | Specialty Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAYDEEP
PATEL
Title or Position: MGR
Credential:
Phone: 352-600-6699