Provider Demographics
NPI:1346633245
Name:KRISHNA HEALTHCARE LLC
Entity Type:Organization
Organization Name:KRISHNA HEALTHCARE LLC
Other - Org Name:MEDPLUS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:NITINKUMAR
Authorized Official - Middle Name:PARSHOTAMBHAI
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-960-2549
Mailing Address - Street 1:5751 BENEVA RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-4105
Mailing Address - Country:US
Mailing Address - Phone:941-960-2549
Mailing Address - Fax:941-960-2579
Practice Address - Street 1:5751 BENEVA RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-4105
Practice Address - Country:US
Practice Address - Phone:941-960-2549
Practice Address - Fax:941-960-2579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-17
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH287813336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2150591OtherPK
FL015004700Medicaid