Provider Demographics
NPI:1932723772
Name:AKB LLC
Entity Type:Organization
Organization Name:AKB LLC
Other - Org Name:SNI PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:ESHETIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-265-2678
Mailing Address - Street 1:842 E CALIFORNIA ST STE A
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76240-4202
Mailing Address - Country:US
Mailing Address - Phone:940-301-6131
Mailing Address - Fax:940-301-6118
Practice Address - Street 1:842 E CALIFORNIA ST STE A
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76240-4202
Practice Address - Country:US
Practice Address - Phone:940-301-6131
Practice Address - Fax:940-301-6118
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AKB LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-06
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX38149946OtherDL