Provider Demographics
NPI:1407519408
Name:SHREEHARIDHAM INC
Entity type:Organization
Organization Name:SHREEHARIDHAM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DHARMENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:VAGHASIYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-268-6486
Mailing Address - Street 1:760 WASHBURN AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-3303
Mailing Address - Country:US
Mailing Address - Phone:951-268-6486
Mailing Address - Fax:
Practice Address - Street 1:760 WASHBURN AVE STE 1
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-3303
Practice Address - Country:US
Practice Address - Phone:951-268-6486
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-16
Last Update Date:2021-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy