Organization
SHIVAJI GROUP INC
Active
Other names
lake pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MAHESH L PATEL (OWNER)
(904) 786-3005
Entity
Organization
Contact information
Practice address
5875 SAN JUAN AVE SUIT # C, JACKSONVILLE, FL 32210
(904) 786-3005
Mailing address
5890 SW 43RD STREET RD, OCALA, FL 34474-9554
(904) 786-3005
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
FL
Other
Enumeration date
03/03/2011
Last updated
03/12/2013
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