Organization
KRISHNA PHARMACY LLC
Active
Other names
Riverdale Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JIGNESH PATEL (MANAGER)
(239) 362-2760
Entity
Organization
Contact information
Practice address
14102 PALM BEACH BLVD, FORT MYERS, FL 33905-2244
(239) 362-2760
(239) 362-2761
Mailing address
14102 PALM BEACH BLVD, FORT MYERS, FL 33905-2244
(239) 362-2760
(239) 362-2761
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH24294
FL
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001554700
—
FL
01
—
1049786
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/06/2009
Last updated
02/02/2011
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