MEDICARE: AADESH RX LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0004X	Compounding Pharmacy
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	333600000X	Pharmacy
4	3336L0003X	Long Term Care Pharmacy
5	3336C0003X	Community/Retail Pharmacy	PH25225	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2128173	OTHER		PK

General Provider Information

NPI Number	:	1316243686
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AADESH RX LLC

Provider Business Mailing Address
First Line	:	907 10TH ST E
Second Line	:
City	:	PALMETTO
State	:	FL
Zip	:	34221-4131
Country	:	US
Telephone Number	:	941-404-4121
Fax Number	:	941-404-4122

Provider Business Practice Location Address
First Line	:	907 10TH ST E
Second Line	:
City	:	PALMETTO
State	:	FL
Zip	:	34221-4131
Country	:	US
Telephone Number	:	941-404-4121
Fax Number	:	941-404-4122

Authorized Official
Title or Position	:	PRESIDENT
Name	:	VIKRAM BACHUBHAI RAO
Credential	:
Telephone Number	:	863-774-3536

Provider Enumeration Date	:	02/04/2011
Last Update Date	:	12/15/2020

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Directions to “AADESH RX LLC ” Practice Location

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