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General NPI Number Information
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NPI Number | 1174213516
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Entity Type | Organization
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Legal Business Name | VANASHREE AYURVEDA
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Dates
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Enumeration Date | 05/09/2023
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Last Update Date | 05/09/2023
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Provider Practice Location Address
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Address Line | 5800 BAKER RD
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City | MINNETONKA
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State | MN
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Zip | 55345-5965
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Country | US
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Telephone | 763-328-7582
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Fax |
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Provider Business Mailing Address
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Address Line | 5800 BAKER RD
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City | MINNETONKA
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State | MN
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Zip | 55345-5965
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Country | US
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Telephone | 763-328-7582
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF MARKETING AND BUSINESS
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Name | BHUSHAN GADAM
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Credential | PHARM D
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Telephone | 763-328-7582
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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