Provider Demographics
NPI:1336536218
Name:LOTUS PHARMA INC.
Entity Type:Organization
Organization Name:LOTUS PHARMA INC.
Other - Org Name:HASLET PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:HIREN
Authorized Official - Middle Name:RAMDUTT
Authorized Official - Last Name:RAVAL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:817-350-0209
Mailing Address - Street 1:1205 AVONDALE HASLET RD STE 200
Mailing Address - Street 2:
Mailing Address - City:HASLET
Mailing Address - State:TX
Mailing Address - Zip Code:76052-3512
Mailing Address - Country:US
Mailing Address - Phone:817-350-0209
Mailing Address - Fax:
Practice Address - Street 1:1205 AVONDALE HASLET RD STE 200
Practice Address - Street 2:
Practice Address - City:HASLET
Practice Address - State:TX
Practice Address - Zip Code:76052-3512
Practice Address - Country:US
Practice Address - Phone:817-350-0209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-18
Last Update Date:2015-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy