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General NPI Number Information
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NPI Number | 1205060464
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Entity Type | Organization
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Legal Business Name | JAI BOHLE INC
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Dates
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Enumeration Date | 05/03/2009
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Last Update Date | 03/17/2017
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Provider Practice Location Address
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Address Line | 2646 NARNIA WAY SUITE 101
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City | LAND O LAKES
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State | FL
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Zip | 34638-7231
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Country | US
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Telephone | 813-388-6875
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Fax | 813-388-6871
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Provider Business Mailing Address
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Address Line | 2646 NARNIA WAY SUITE 101
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City | LAND O LAKES
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State | FL
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Zip | 34638-7231
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Country | US
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Telephone | 813-388-6875
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Fax | 813-388-6871
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | VIPUL PATEL
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Credential |
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Telephone | 813-317-3018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PH24046
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License Number State | FL
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