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General NPI Number Information
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NPI Number | 1215809025
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Entity Type | Organization
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Legal Business Name | SHIVITA RX LLC
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Dates
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Enumeration Date | 09/22/2025
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 5 LACEY RD
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City | FORKED RIVER
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State | NJ
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Zip | 08731-4238
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Country | US
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Telephone | 609-622-5507
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Fax | 609-622-5509
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Provider Business Mailing Address
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Address Line | 5 LACEY RD
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City | FORKED RIVER
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State | NJ
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Zip | 08731-4238
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Country | US
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Telephone | 609-622-5507
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Fax | 609-622-5509
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Authorized Official
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Title or Position | OWNER
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Name | MR. KETANKUMAR B PATEL
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Credential | RPH
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Telephone | 609-622-5507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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