Organization
SIDDH INC
Active
Organization
SIDDH INC
Active
Other names
Town Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MAHENDRA J CHAUDHARI (OWNER)
(908) 868-5461
Entity
Organization
Contact information
Practice address
107 W MAIN ST, IMMOKALEE, FL 34142-3926
(239) 658-1048
(239) 658-1050
Mailing address
11673 PLANTATION PRESERVE CIR S, FORT MYERS, FL 33966-8372
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH28773
FL
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1073903233
NPPES
FL
Enumeration date
01/27/2015
Last updated
10/13/2020
Update your record
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