MEDICARE: PNH 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	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PH31896	OTHER	FL	RETAIL LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831657782
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PNH LLC

Provider Business Mailing Address
First Line	:	2114 MANATEE AVE E
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34208-1660
Country	:	US
Telephone Number	:	941-896-7767
Fax Number	:

Provider Business Practice Location Address
First Line	:	2114 MANATEE AVE E
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34208-1660
Country	:	US
Telephone Number	:	941-896-7767
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	HARSHIL SHAH
Credential	:
Telephone Number	:	941-896-7767

Provider Enumeration Date	:	03/11/2019
Last Update Date	:	09/15/2023

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Directions to “PNH LLC ” Practice Location

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