Organization
SHIVSAI RX LLC
Active
Other names
SANFORD DISCOUNT PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
VIJAY BHALALA (OWNER AND MANAGER)
(407) 323-7922
Entity
Organization
Contact information
Practice address
1808 S FRENCH AVE, SANFORD, FL 32771
(407) 323-7922
(407) 323-7927
Mailing address
1808 S FRENCH AVE, SANFORD, FL 32771
(407) 323-7922
(407) 323-7927
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013317100
—
FL
01
—
PH28250
PHARMACY LICENSE
FL
Enumeration date
05/15/2014
Last updated
09/20/2022
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