Organization
ASHWINI HEALTHCARE LLC
Active
Other names
MELBOURNE DISCOUNT PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MANASA THIMMEGOWDA (MGRM)
(321) 752-9125
Entity
Organization
Contact information
Practice address
401 N WICKHAM RD, SUITE W AND X, MELBOURNE, FL 32935-8659
(321) 751-7885
(321) 751-7886
Mailing address
816 AUTUMN GLEN DR, MELBOURNE, FL 32940-6423
(321) 752-9125
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH24577
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002560400
—
FL
01
—
1055703
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
04/07/2010
Last updated
10/25/2011
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