Provider Demographics
NPI:1194028605
Name:SHRI SAI LLC
Entity Type:Organization
Organization Name:SHRI SAI LLC
Other - Org Name:CAREPLUS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY IN-CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:CHETAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KHATRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-446-6473
Mailing Address - Street 1:344B W 24TH STREET
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364
Mailing Address - Country:US
Mailing Address - Phone:928-276-4693
Mailing Address - Fax:928-276-4694
Practice Address - Street 1:344B W 24TH ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6455
Practice Address - Country:US
Practice Address - Phone:928-276-4693
Practice Address - Fax:928-276-4694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-06
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZY0053223336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0356902OtherNCPDP PROVIDER IDENTIFICATION NUMBER