Organization
SHIV PHARMACY INC
Active
Other names
MLK Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PARESH PATEL (PHARMACIST)
(912) 662-0300
Entity
Organization
Contact information
Practice address
718 MARTIN LUTHER KING JR BLVD STE A, SAVANNAH, GA 31401-5570
(912) 662-0300
(912) 662-0302
Mailing address
718 MARTIN LUTHER KING JR BLVD, SUITE A, SAVANNAH, GA 31401-5570
(912) 662-0300
(912) 662-0302
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE010203
GA
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003170361A
—
GA
01
—
2155501
PK
—
Enumeration date
12/03/2015
Last updated
01/22/2016
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