Provider Demographics
NPI:1043517949
Name:ISHAAN AND RIHAAN LLC
Entity Type:Organization
Organization Name:ISHAAN AND RIHAAN LLC
Other - Org Name:THE GREEN CROSS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AILENE
Authorized Official - Middle Name:
Authorized Official - Last Name:SALSGIVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-460-7730
Mailing Address - Street 1:1300 E BAY DR STE E
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-1004
Mailing Address - Country:US
Mailing Address - Phone:727-767-9550
Mailing Address - Fax:727-767-9505
Practice Address - Street 1:1300 E BAY DR STE E
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-1004
Practice Address - Country:US
Practice Address - Phone:727-767-9550
Practice Address - Fax:727-767-9505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-12
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH25224333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1043517949Medicaid
FL1043517949Medicaid