Provider Demographics
NPI:1326603051
Name:MAA ASHAPURA INC
Entity Type:Organization
Organization Name:MAA ASHAPURA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GAURAV
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHATMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-438-1161
Mailing Address - Street 1:10479 N FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:CITRUS SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34434-3268
Mailing Address - Country:US
Mailing Address - Phone:352-897-4615
Mailing Address - Fax:
Practice Address - Street 1:11386 E HIGHWAY 316
Practice Address - Street 2:
Practice Address - City:FORT MC COY
Practice Address - State:FL
Practice Address - Zip Code:32134-8114
Practice Address - Country:US
Practice Address - Phone:352-438-1161
Practice Address - Fax:352-438-1160
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MAA ASHAPURA INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPH32005OtherFLORIDA STATE BOARD OF PHARMACY