Provider Demographics
NPI:1366965360
Name:G & R PHARMACY INC
Entity type:Organization
Organization Name:G & R PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAJESH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:352-270-2281
Mailing Address - Street 1:2432 W ELM BLOSSOM ST
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:FL
Mailing Address - Zip Code:34465-3037
Mailing Address - Country:US
Mailing Address - Phone:352-270-2281
Mailing Address - Fax:352-527-2629
Practice Address - Street 1:946 E NORVELL BRYANT HWY
Practice Address - Street 2:
Practice Address - City:HERNANDO
Practice Address - State:FL
Practice Address - Zip Code:34442-2826
Practice Address - Country:US
Practice Address - Phone:352-419-8949
Practice Address - Fax:855-829-8663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014674200Medicaid
FL014674200Medicaid