Organization
SHIVKRUPA INC
Active
Other names
Avon Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MAULIK PATEL (OWNER)
(863) 453-3884
Entity
Organization
Contact information
Practice address
1577 US HIGHWAY 27 N, AVON PARK, FL 33825-2150
(863) 453-3884
(863) 453-3885
Mailing address
1577 US HIGHWAY 27 N, AVON PARK, FL 33825-2150
(863) 453-3884
(863) 453-3885
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH26719
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009303300
—
FL
05
—
017061900
—
FL
01
—
2139320
PK
—
Enumeration date
03/07/2013
Last updated
02/16/2017
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