MEDICARE: RADHIKA CORP

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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	PH21322	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	2004561	OTHER		PK

General Provider Information

NPI Number	:	1326021833
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RADHIKA CORP

Provider Business Mailing Address
First Line	:	145 E BROAD ST
Second Line	:
City	:	GROVELAND
State	:	FL
Zip	:	34736-2501
Country	:	US
Telephone Number	:	352-429-1353
Fax Number	:	352-429-1383

Provider Business Practice Location Address
First Line	:	145 E BROAD ST
Second Line	:
City	:	GROVELAND
State	:	FL
Zip	:	34736-2501
Country	:	US
Telephone Number	:	352-429-1353
Fax Number	:	352-429-1383

Authorized Official
Title or Position	:	VP
Name	:	DUSHYANT PATEL
Credential	:
Telephone Number	:	352-429-1353

Provider Enumeration Date	:	11/29/2005
Last Update Date	:	05/24/2016

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Directions to “RADHIKA CORP ” Practice Location

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