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

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
5712131OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names

  • SAFESCRIPT PHARMACY Doing business as

Other providers in Bushnell, FL

All providers in Bushnell, FL · Community/Retail Pharmacy in Florida

Sources for this page

Verify at the official NPI Registry.