Provider Demographics
NPI:1699370759
Name:GANDHI, SHREEKANT (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:SHREEKANT
Middle Name:
Last Name:GANDHI
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SUPER G PHARMACY 0385
Mailing Address - Street 2:300 EDEN SQUARE
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701
Mailing Address - Country:US
Mailing Address - Phone:302-832-0156
Mailing Address - Fax:844-411-6342
Practice Address - Street 1:SUPER G PHARMACY 0385
Practice Address - Street 2:300 EDEN SQUARE
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701
Practice Address - Country:US
Practice Address - Phone:302-832-0156
Practice Address - Fax:844-411-6342
Is Sole Proprietor?:No
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0002275183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist