Provider Demographics
NPI:1831396530
Name:PN GROUP LLC
Entity type:Organization
Organization Name:PN GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAJNISH
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHTA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:727-868-4040
Mailing Address - Street 1:10806 US HIGHWAY 19
Mailing Address - Street 2:SUITE#105
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-2563
Mailing Address - Country:US
Mailing Address - Phone:727-868-4040
Mailing Address - Fax:727-868-4077
Practice Address - Street 1:10806 US HIGHWAY 19
Practice Address - Street 2:SUITE#105
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-2563
Practice Address - Country:US
Practice Address - Phone:727-868-4040
Practice Address - Fax:727-868-4077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH227673336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy