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General NPI Number Information
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NPI Number | 1609089150
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Entity Type | Organization
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Legal Business Name | SUDDHA PHARMACY, LLC
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 255 SUNRISE AVE
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City | PALM BEACH
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State | FL
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Zip | 33480
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Country | US
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Telephone | 561-833-3348
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Fax | 561-832-7783
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Provider Business Mailing Address
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Address Line | 255 SUNRISE AVE
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City | PALM BEACH
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State | FL
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Zip | 33480
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DIPTI PATEL
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Credential |
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Telephone | 561-833-3348
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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 | PH21413
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License Number State | FL
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