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General NPI Number Information
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NPI Number | 1346747375
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Entity Type | Organization
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Legal Business Name | SHRI GOVIND LLC
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Dates
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Enumeration Date | 04/06/2018
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Last Update Date | 09/20/2018
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Provider Practice Location Address
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Address Line | 200 MOODY BLVD
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City | FLAGLER BEACH
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State | FL
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Zip | 32136-3372
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Country | US
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Telephone | 386-439-2039
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Fax | 386-246-7571
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Provider Business Mailing Address
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Address Line | 200 MOODY BLVD
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City | FLAGLER BEACH
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State | FL
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Zip | 32136-3372
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Country | US
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Telephone | 386-777-0777
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Fax | 386-426-6600
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | MR. PRASHANT K PATEL
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Credential | MS, MBA, R PH
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Telephone | 904-728-7283
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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 | PH31331
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License Number State | FL
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