Provider Demographics
NPI:1457045999
Name:PRAKRUTI LLC
Entity Type:Organization
Organization Name:PRAKRUTI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SULBHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:561-870-5554
Mailing Address - Street 1:19585 STATE ROAD 7 STE N
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498-4744
Mailing Address - Country:US
Mailing Address - Phone:561-870-5554
Mailing Address - Fax:
Practice Address - Street 1:19585 STATE ROAD 7 STE N
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33498-4744
Practice Address - Country:US
Practice Address - Phone:561-409-4495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy