Rissan Inc
Organization Active NPI Community/Retail Pharmacy · Bushnell, FL
NPI 1710239249 · NPPES record last updated Sep 8, 2020
Key facts
- NPI
- 1710239249
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- PH26400 (FL)
- Legal business name
- RISSAN INC
- Practice address
- 211 N Market St
Bushnell, FL 33513-6108 - Phone
- (352) 793-8000
- Fax
- (352) 793-8007
- NPI assigned
- Oct 8, 2012
- Organization subpart
- No
Authorized official
- Name
- Tejas Gandhi
- Title
- VP
- Phone
- (352) 793-8000
Practitioners 2
-
Tejas G Gandhi, PHARMACIST
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210914002424 | FL | Part B Supplier - Mass Immunization (Roster Biller Only) | 5092133876 | Practice locations: Bushnell, FL |
National Provider Directory
Locations
880 N Main St
Bushnell, FL 33513
211 N Market St
Bushnell, FL 33513
Phone (352) 348-4049
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Community/Retail Pharmacy | 3336C0003X | PH26400 | FL | Yes |
| Compounding Pharmacy | 3336C0004X |
Addresses
Primary practice location
211 N Market St
Bushnell, FL 33513-6108
Mailing address
211 N Market St
Bushnell, FL 33513-6108
Phone (352) 793-8000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5712131 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER |
Other names
- SAFESCRIPT PHARMACY
Other providers in Bushnell, FL
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- Satyajit Rana
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- Renovation Integrative Health
- Emma J Ridley
- Carlos Manuel Rodriguez III
- Shaunna Michelle Rodriguez
- Lori Sadecky
- Steven Sadecky
- Safe Haven Oaks, Inc.
All providers in Bushnell, FL · Community/Retail Pharmacy in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.