Organization
KIRTI Z SHAH INC
Active
Other names
Desert Medical Pharmacy #2
Organization subpart
No
Provider details
NPI number
Authorized official
KIRTI SHAH PD (OWNER / PIC)
(760) 592-4442
Entity
Organization
Contact information
Practice address
401 W MAIN ST, EL CENTRO, CA 92243-3006
(760) 592-4442
(760) 592-4652
Mailing address
401 W MAIN ST, EL CENTRO, CA 92243-3006
(760) 592-4442
(760) 592-4652
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY51446
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2140504
PK
—
Enumeration date
04/12/2013
Last updated
09/03/2013
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