Provider Demographics
NPI:1790013274
Name:OME SHREE INC
Entity Type:Organization
Organization Name:OME SHREE INC
Other - Org Name:CAMPOSTELLA COMMUNITY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:SANDIPKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-373-8960
Mailing Address - Street 1:2709 CAMPOSTELLA RD
Mailing Address - Street 2:SUITE K
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23324-3604
Mailing Address - Country:US
Mailing Address - Phone:757-494-5960
Mailing Address - Fax:
Practice Address - Street 1:2709 CAMPOSTELLA RD STE K
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23324-3604
Practice Address - Country:US
Practice Address - Phone:757-494-5960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-23
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA02010043213336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4841967OtherNCPDP PROVIDER IDENTIFICATION NUMBER