Organization
MAA BHAWANI INC
Active
Organization
MAA BHAWANI INC
Active
Other names
G & R HEALTH MART #2
Organization subpart
No
Provider details
NPI number
Authorized official
RAJESH PATEL PHARM D (OWNER/PRESIDENT)
(352) 527-3111
Entity
Organization
Contact information
Practice address
5691 S SUNCOAST BLVD, HOMOSASSA, FL 34446-2605
(352) 628-0096
(352) 527-2629
Mailing address
3791 N LECANTO HWY, BEVERLY HILLS, FL 34465-3559
(352) 527-3111
(352) 527-2629
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH25878
FL
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2133257
PK
—
Enumeration date
07/15/2011
Last updated
02/28/2017
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