# SHIV KRUPA HEALTHCARE INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** JDX PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023668936
- **Authorized official:** NISHANT DILIP PANCHAL PHARM D (PRESIDENT/CEO)
- **Authorized official phone:** (805) 922-1747

## Contact information

- **Practice address:** 1504 S BROADWAY, SANTA MARIA, CA 93454-7214
- **Practice address phone:** (805) 922-1747
- **Practice address fax:** (805) 925-6499
- **Mailing address:** 1504 S BROADWAY, SANTA MARIA, CA 93454-7214
- **Mailing address phone:** (805) 922-1747
- **Mailing address fax:** (805) 925-6499

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 09/13/2019
- **Last updated:** 03/19/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | PHY60021 | BOARD OF PHARMACY | CA |