MEDICARE: SHRINATHJEE 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	3336L0003X	Long Term Care Pharmacy

General Provider Information

NPI Number	:	1861234122
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHRINATHJEE LLC

Provider Business Mailing Address
First Line	:	1825 TAMIAMI TRL UNIT B7
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33948-1056
Country	:	US
Telephone Number	:	941-979-5301
Fax Number	:	941-296-7800

Provider Business Practice Location Address
First Line	:	1825 TAMIAMI TRL UNIT B7
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33948-1056
Country	:	US
Telephone Number	:	941-979-5301
Fax Number	:	941-296-7800

Authorized Official
Title or Position	:	AUTHORIZED OFFICER
Name	:	NIRAJ BANJARA
Credential	:
Telephone Number	:	941-979-5301

Provider Enumeration Date	:	06/08/2024
Last Update Date	:	06/10/2024

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