Shri Sairam Drugs LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PS31035 Issued in FL

Legal business name

SHRI SAIRAM DRUGS LLC

Doing business as

Madison Street Pharmacy

Practice address

395 W Madison St
Starke, FL 32091

Phone

(904) 964-7774

Fax

(904) 964-7807

NPI assigned

Jan 29, 2007

Last updated

Mar 15, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Venkatakiran Kumar Kali

Title

President

Phone

(972) 261-9694

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Madison Street Pharmacy Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tracy Allen Abbott

  • Pharmacist
  • Starke, FL
  • NPI 1316474513
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521072000000",
    "number": "1043356215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 W MADISON ST",
            "city": "STARKE",
            "state": "FL",
            "postal_code": "32091",
            "telephone_number": "904-964-7774",
            "fax_number": "904-964-7807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 W MADISON ST",
            "city": "STARKE",
            "state": "FL",
            "postal_code": "32091",
            "telephone_number": "904-964-7774",
            "fax_number": "904-964-7807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHRI SAIRAM DRUGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2018-03-15",
        "status": "A",
        "authorized_official_last_name": "KALI",
        "authorized_official_first_name": "VENKATAKIRAN",
        "authorized_official_middle_name": "KUMAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-261-9694"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH19105",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PS31035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026030400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madison Street Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Starke, FL
• Providers in Starke, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.