Organization
SHIVAM LLC
Active
Other names
Cherry Rd pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BHARAT KANANI RPH (OWNER)
(561) 601-8680
Entity
Organization
Contact information
Practice address
1280 N MILITARY TRL, WEST PALM BEACH, FL 33409-6015
(561) 249-1524
(561) 249-1526
Mailing address
1280 N MILITARY TRL, WEST PALM BEACH, FL 33409-6015
(561) 249-1524
(561) 249-1526
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH24278
FL
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001541000
—
FL
01
—
1049166
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/08/2009
Last updated
01/31/2010
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