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General NPI Number Information
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NPI Number | 1902621840
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Entity Type | Organization
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Legal Business Name | GOKULESH LLC
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Dates
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Enumeration Date | 11/16/2024
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 14011 WORTH AVE # 120
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City | WOODBRIDGE
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State | VA
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Zip | 22192-4123
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Country | US
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Telephone | 703-686-4505
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Fax | 703-686-4502
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Provider Business Mailing Address
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Address Line | 13014 WINTER WILLOW DR
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City | FAIRFAX
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State | VA
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Zip | 22030-8221
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Country | US
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Telephone | 703-200-2945
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KAMINI SHAH
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Credential |
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Telephone | 703-200-2945
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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 |
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License Number State |
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