Provider Demographics
NPI:1205426285
Name:PUSHTI CORPORATION
Entity type:Organization
Organization Name:PUSHTI CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BHAVESHKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:RAKHOLIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-677-1114
Mailing Address - Street 1:39872 LOS ALAMOS RD STE A10
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-5871
Mailing Address - Country:US
Mailing Address - Phone:951-677-1114
Mailing Address - Fax:951-677-1121
Practice Address - Street 1:39872 LOS ALAMOS RD STE A10
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-5871
Practice Address - Country:US
Practice Address - Phone:951-677-1114
Practice Address - Fax:951-677-1121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy