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General NPI Number Information
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NPI Number | 1780489609
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Entity Type | Organization
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Legal Business Name | PODARIS GROUP LLC
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Dates
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Enumeration Date | 02/14/2025
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 6301 NW 5TH WAY STE 1410B
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309-6131
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Country | US
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Telephone | 843-276-4195
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Fax |
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Provider Business Mailing Address
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Address Line | 711 PALM BLVD
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City | ISLE OF PALMS
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State | SC
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Zip | 29451-2151
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Country | US
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Telephone | 843-276-4195
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOHN NESBITT
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Credential |
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Telephone | 843-276-4195
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number |
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License Number State |
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