Provider Demographics
NPI:1104980952
Name:SHREE PHARMACY LLC
Entity type:Organization
Organization Name:SHREE PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST IN CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:DARSHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PAREKH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD RPH
Authorized Official - Phone:215-284-4790
Mailing Address - Street 1:5604 N BROAD ST
Mailing Address - Street 2:PHARMACY
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19141-2306
Mailing Address - Country:US
Mailing Address - Phone:215-927-0224
Mailing Address - Fax:215-927-0813
Practice Address - Street 1:5604 N BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19141-2306
Practice Address - Country:US
Practice Address - Phone:215-927-0224
Practice Address - Fax:215-927-0813
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHREE PHARMACY, LLC DBA DELCO PH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-19
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001057115Medicaid