Organization
SHRI SAIRAM DRUGS LLC
Active
Other names
Madison Street Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
VENKATAKIRAN KUMAR KALI (PRESIDENT)
(972) 261-9694
Entity
Organization
Contact information
Practice address
395 W MADISON ST, STARKE, FL 32091
(904) 964-7774
(904) 964-7807
Mailing address
395 W MADISON ST, STARKE, FL 32091
(904) 964-7774
(904) 964-7807
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
PH19105
FL
3336C0003X
Community/Retail Pharmacy
Primary
PS31035
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
026030400
—
FL
Enumeration date
01/29/2007
Last updated
03/15/2018
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