Provider Demographics
NPI:1689070286
Name:SHAMBHU INC.
Entity Type:Organization
Organization Name:SHAMBHU INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VARSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAUDHARI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:407-902-7543
Mailing Address - Street 1:5144 SW 82ND TER
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-7406
Mailing Address - Country:US
Mailing Address - Phone:407-902-7543
Mailing Address - Fax:
Practice Address - Street 1:232 NE 1ST AVE
Practice Address - Street 2:
Practice Address - City:HIGH SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32643-9443
Practice Address - Country:US
Practice Address - Phone:386-454-1586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-08
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy