Provider Demographics
NPI:1891821203
Name:SUTHAR LTD
Entity Type:Organization
Organization Name:SUTHAR LTD
Other - Org Name:MEDICINE SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PARESH
Authorized Official - Middle Name:
Authorized Official - Last Name:SUTHAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:2766-666-6614
Mailing Address - Street 1:808 MEMORIAL BLVD S
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-6417
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:808 MEMORIAL BLVD S
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-6417
Practice Address - Country:US
Practice Address - Phone:276-666-6614
Practice Address - Fax:276-666-6615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0201002703333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4824365OtherOTHER ID NUMBER-COMMERCIAL NUMBER
4824365OtherOTHER ID NUMBER-COMMERCIAL NUMBER
VABT6649810OtherDEA #