Provider Demographics
NPI:1679076517
Name:GNSP CORP
Entity Type:Organization
Organization Name:GNSP CORP
Other - Org Name:RX OASIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:
Authorized Official - First Name:KAMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-677-6000
Mailing Address - Street 1:9304 BALM RIVERVIEW RD
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-5104
Mailing Address - Country:US
Mailing Address - Phone:813-677-6000
Mailing Address - Fax:813-677-6077
Practice Address - Street 1:9304 BALM RIVERVIEW RD
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33569-5104
Practice Address - Country:US
Practice Address - Phone:813-677-6000
Practice Address - Fax:813-677-6077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-16
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH259263336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004560000Medicaid
2176273OtherPK