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General NPI Number Information
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NPI Number | 1508842931
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Entity Type | Organization
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Legal Business Name | SHANTI PHARMACY CORP
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Dates
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Enumeration Date | 12/18/2005
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Last Update Date | 02/13/2024
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Provider Practice Location Address
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Address Line | 5105 CHURCH AVE
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City | BROOKLYN
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State | NY
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Zip | 11203-3511
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Country | US
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Telephone | 718-922-3400
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Fax | 718-922-0348
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Provider Business Mailing Address
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Address Line | 5105 CHURCH AVE
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City | BROOKLYN
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State | NY
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Zip | 11203-3511
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Country | US
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Telephone | 718-922-3400
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Fax | 718-922-0348
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Authorized Official
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Title or Position | SECRETARY
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Name | MR. MILIND S SUVARNAKAR
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Credential | PHARMACIST
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Telephone | 718-922-3400
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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 | 020652
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License Number State | NY
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