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Organization
SHIV KRUPA HEALTHCARE INC
Active
Organization
SHIV KRUPA HEALTHCARE INC
Active
Other names
JDX PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
NISHANT DILIP PANCHAL PHARM D (PRESIDENT/CEO)
(805) 922-1747
Entity
Organization
Contact information
Practice address
1504 S BROADWAY, SANTA MARIA, CA 93454-7214
(805) 922-1747
(805) 925-6499
Mailing address
1504 S BROADWAY, SANTA MARIA, CA 93454-7214
(805) 922-1747
(805) 925-6499
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHY60021
BOARD OF PHARMACY
CA
Enumeration date
09/13/2019
Last updated
03/19/2025
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