Provider Demographics
NPI:1548772080
Name:MAA ASHAPURA INC
Entity Type:Organization
Organization Name:MAA ASHAPURA INC
Other - Org Name:RAINBOW DISCOUNT DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANUP
Authorized Official - Middle Name:H
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-897-4615
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:
Mailing Address - Fax:
Practice Address - Street 1:10479 N FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:CITRUS SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34434-3268
Practice Address - Country:US
Practice Address - Phone:352-615-6023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-24
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH308953336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy