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General NPI Number Information
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NPI Number | 1538576152
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Entity Type | Organization
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Legal Business Name | KRISHNA HEALTHMEDS LLC
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Dates
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Enumeration Date | 07/15/2014
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Last Update Date | 05/07/2015
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Provider Practice Location Address
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Address Line | 4885 MEXICO RD
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City | SAINT PETERS
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State | MO
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Zip | 63376-2577
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Country | US
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Telephone | 636-244-5385
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Fax |
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Provider Business Mailing Address
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Address Line | 4885 MEXICO RD
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City | SAINT PETERS
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State | MO
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Zip | 63376-2577
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Country | US
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Telephone | 636-244-5385
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | RAJ JHALA
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Credential |
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Telephone | 951-818-9710
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | 2014023957
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 2014023957
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 2014023957
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License Number State | MO
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