Organization
KIRTI Z SHAH INC
Active
Other names
DESERT MEDICAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KIRTI SHAH PHARM.D. (OWNER)
(760) 353-5130
Entity
Organization
Contact information
Practice address
1600 S IMPERIAL AVE, STE 12, EL CENTRO, CA 92243-4242
(760) 353-5130
(760) 353-4556
Mailing address
1600 S IMPERIAL AVE, STE 12, EL CENTRO, CA 92243-4242
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
CA
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
PHY30417
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0531651
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA304170
—
CA
Enumeration date
08/10/2006
Last updated
01/29/2013
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