Provider Demographics
NPI:1326462946
Name:GENERIC SPECIALTIES INC
Entity Type:Organization
Organization Name:GENERIC SPECIALTIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ASHWIN
Authorized Official - Middle Name:ARVIND
Authorized Official - Last Name:MEHTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-445-9581
Mailing Address - Street 1:8007 HORSE FERRY RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-5977
Mailing Address - Country:US
Mailing Address - Phone:407-445-9581
Mailing Address - Fax:
Practice Address - Street 1:1701 ACME ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805-3603
Practice Address - Country:US
Practice Address - Phone:407-445-9581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GENERIC SPECIALTIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-02-18
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy