Provider Demographics
NPI:1649608837
Name:SRI CAITANYA NITAI INC
Entity type:Organization
Organization Name:SRI CAITANYA NITAI INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BHARAT
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:702-301-6503
Mailing Address - Street 1:9801 WINTER PALACE DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-8639
Mailing Address - Country:US
Mailing Address - Phone:702-301-6503
Mailing Address - Fax:
Practice Address - Street 1:1820 E LAKE MEAD BLVD
Practice Address - Street 2:UNIT: N
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-7134
Practice Address - Country:US
Practice Address - Phone:702-301-6503
Practice Address - Fax:702-387-8612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-24
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPPLIED & APPROVED3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy