Healthcare Provider Details

I. General information

NPI: 1437970340
Provider Name (Legal Business Name): SHANTI BHUVAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2024
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 RADIO DR
LEWIS CENTER OH
43035-7112
US

IV. Provider business mailing address

PO BOX 629
LEWIS CENTER OH
43035-0629
US

V. Phone/Fax

Practice location:
  • Phone: 614-285-6553
  • Fax:
Mailing address:
  • Phone: 614-285-6553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DIPAL A PATEL
Title or Position: CEO
Credential:
Phone: 614-285-6553