Provider Demographics
NPI:1184024788
Name:MAAHI LLC
Entity Type:Organization
Organization Name:MAAHI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NIKHIL
Authorized Official - Middle Name:
Authorized Official - Last Name:GADGIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-786-9181
Mailing Address - Street 1:417 TAMIAMI TRL S
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-2600
Mailing Address - Country:US
Mailing Address - Phone:941-786-9181
Mailing Address - Fax:941-786-9183
Practice Address - Street 1:417 TAMIAMI TRL S
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-2600
Practice Address - Country:US
Practice Address - Phone:941-786-9181
Practice Address - Fax:941-786-9183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-02
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH284293336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014819200Medicaid
2147671OtherPK