Provider Demographics
NPI:1154674968
Name:DHANALAKSHMI RX, LLC
Entity Type:Organization
Organization Name:DHANALAKSHMI RX, LLC
Other - Org Name:LIBERTY DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RAM
Authorized Official - Middle Name:PRASAD
Authorized Official - Last Name:CHOUDHURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-752-4302
Mailing Address - Street 1:659 NW 62ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33150-4329
Mailing Address - Country:US
Mailing Address - Phone:305-759-3339
Mailing Address - Fax:
Practice Address - Street 1:659 NW 62ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33150-4329
Practice Address - Country:US
Practice Address - Phone:305-759-3339
Practice Address - Fax:305-759-6335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-17
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH26427332B00000X, 3336C0003X, 3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy