Organization
MAHANT PHARMACY INC
Active
Other names
FLORESTA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
URMIL SHAH (PRESIDENT)
(848) 667-3791
Entity
Organization
Contact information
Practice address
1550 SE FLORESTA DR, PORT ST LUCIE, FL 34983-4069
(772) 340-4142
(772) 785-5753
Mailing address
1550 SE FLORESTA DR, PORT ST LUCIE, FL 34983-4069
(772) 340-4142
(772) 785-5753
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH30595
FL
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019934700
—
FL
Enumeration date
02/01/2008
Last updated
06/29/2021
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