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General NPI Number Information
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NPI Number | 1831616515
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Entity Type | Organization
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Legal Business Name | PEARL SHAH LLC
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Dates
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Enumeration Date | 08/24/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 6399 38TH AVE N STE A5
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City | SAINT PETERSBURG
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State | FL
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Zip | 33710-1651
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Country | US
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Telephone | 727-201-9500
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Fax | 727-201-9501
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Provider Business Mailing Address
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Address Line | 6399 38TH AVE N STE A5
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City | SAINT PETERSBURG
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State | FL
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Zip | 33710-1651
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Country | US
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Telephone | 727-201-9500
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Fax | 727-201-9501
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Authorized Official
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Title or Position | MGRM
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Name | AMIT KUMAR DHIMAN
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Credential |
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Telephone | 727-389-5900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | PH27659
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License Number State | FL
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