Provider Demographics
NPI:1841427119
Name:VARDHMAN LLC
Entity type:Organization
Organization Name:VARDHMAN LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:PIYASI
Authorized Official - Middle Name:
Authorized Official - Last Name:DADIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-937-4420
Mailing Address - Street 1:6725 W INDIANTOWN ROAD SUITE #40
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-4620
Mailing Address - Country:US
Mailing Address - Phone:954-530-9318
Mailing Address - Fax:954-530-9854
Practice Address - Street 1:6725 W INDIANTOWN ROAD SUITE #40
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-4620
Practice Address - Country:US
Practice Address - Phone:954-530-9318
Practice Address - Fax:954-530-9854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-15
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
FLPH241163336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2120636OtherPK
FL001537900Medicaid