Provider Demographics
NPI:1851815856
Name:SHREE HARI PSM INC
Entity Type:Organization
Organization Name:SHREE HARI PSM INC
Other - Org Name:MEADOWS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HELI
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAUDHARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-619-4461
Mailing Address - Street 1:4761 N CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-7940
Mailing Address - Country:US
Mailing Address - Phone:561-619-4461
Mailing Address - Fax:561-619-4668
Practice Address - Street 1:4761 N CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-7940
Practice Address - Country:US
Practice Address - Phone:561-619-4461
Practice Address - Fax:561-619-4668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-01
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
FLPH308813336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2170267OtherPK
FL023084800Medicaid