NPIMap

Organization Active NPI

Giriraj LLC

Doing business as Lakewales Pharmacy

  • Community/Retail Pharmacy
  • Lake Wales, FL
National Provider Identifier
1497099055
Registry record updated Feb 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH26509 Issued in FL
Legal business name
GIRIRAJ LLC
Doing business as
Lakewales Pharmacy
Practice address
1322 State Road 60 E
Lake Wales, FL 33853-4322
Phone
(863) 676-0400
Fax
(863) 676-0445
NPI assigned
Nov 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2017

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

Authorized official

Name
Gopika Trivedi
Title
Owner
Phone
(863) 676-0400

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PH26509 FL Primary

Addresses

Primary practice location

1322 State Road 60 E
Lake Wales, FL 33853-4322

Mailing address

1322 Stae Rd 60 E
Lakewales, FL 33853
Phone (863) 676-0400

Other identifiers 1

IdentifierTypeStateIssuer
2137946OtherPK

Other names 1

  • Lakewales Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Giriraj LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1353369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487635200000",
    "number": "1497099055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 STAE RD 60 E",
            "city": "LAKEWALES",
            "state": "FL",
            "postal_code": "33853",
            "telephone_number": "863-676-0400",
            "fax_number": "863-676-0445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 STATE ROAD 60 E",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338534322",
            "telephone_number": "863-676-0400",
            "fax_number": "863-676-0445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIRIRAJ LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-20",
        "last_updated": "2017-02-21",
        "status": "A",
        "authorized_official_last_name": "TRIVEDI",
        "authorized_official_first_name": "GOPIKA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-676-0400"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH26509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2137946",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakewales Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Wales, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; 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.