Healthcare Provider Details

I. General information

NPI: 1548241870
Provider Name (Legal Business Name): SHRI KRISHNA DRUGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 07/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 PENNSYLVANIA AVE
FT WORTH TX
76104-2221
US

IV. Provider business mailing address

708 PENNSYLVANIA AVE
FT WORTH TX
76104-2221
US

V. Phone/Fax

Practice location:
  • Phone: 817-877-3677
  • Fax: 817-877-9981
Mailing address:
  • Phone: 817-877-3677
  • Fax: 817-877-9981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number28479
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: VENKATAKIRAN KALI
Title or Position: DIRECTOR
Credential:
Phone: 817-877-3677