Provider Demographics
NPI:1437281797
Name:SHRI DIVYA DRUGS LLC
Entity Type:Organization
Organization Name:SHRI DIVYA DRUGS LLC
Other - Org Name:GADDIS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VENKATAKIRAN
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:KALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-261-9694
Mailing Address - Street 1:302 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COTULLA
Mailing Address - State:TX
Mailing Address - Zip Code:78014-2153
Mailing Address - Country:US
Mailing Address - Phone:830-879-2323
Mailing Address - Fax:830-879-3260
Practice Address - Street 1:302 N MAIN ST
Practice Address - Street 2:
Practice Address - City:COTULLA
Practice Address - State:TX
Practice Address - Zip Code:78014-2153
Practice Address - Country:US
Practice Address - Phone:830-879-2323
Practice Address - Fax:830-879-3260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX313873336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy