Om Shri Ganesh LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH25990 Issued in FL

Legal business name

OM SHRI GANESH LLC

Doing business as

Ricker Pharmacy

Practice address

7628 103Rd St Ste 5
Jacksonville, FL 32210-8719

Phone

(904) 900-3500

Fax

(904) 900-3505

NPI assigned

Mar 7, 2012

Organization subpart

No

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

Authorized official

Name

Tejas Patel

Title

Managing Member

Phone

(904) 208-8137

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• Ricker Pharmacy Doing business as

Locations

Practitioners 2

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

• Mitesh R Patel, RPH

  • Pharmacist
  • Jacksonville, FL
  • NPI 1003135096
  NPD
• Tejaskumar M Patel

  • Pharmacist
  • Jacksonville, FL
  • NPI 1417276916
  NPD

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

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710979200000",
    "number": "1720352776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7628 103RD ST STE 5",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322108719",
            "telephone_number": "904-900-3500",
            "fax_number": "904-900-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7628 103RD ST STE 5",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322108719",
            "telephone_number": "904-900-3500",
            "fax_number": "904-900-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OM SHRI GANESH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-07",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "TEJAS",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "904-208-8137"
    },
    "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": "PH25990",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2134119",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006295900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ricker Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Olufisayo Arubuola M D P a
• Antionette L Olukunle
• Jeremiah Tobi Oluwadamisi, M.D.
• Valeria Olvera
• Eamon Terence Olwell, MD
• Om TSM LLC (Durbin Pharmacy)
• Om TSM LLC (Durbin Pharmacy)
• Omajus Medical Services LLC
• Sven Peter Oman, MD
• Omar Kawwaff

• Community/Retail Pharmacy in Jacksonville, FL
• Providers in Jacksonville, 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 21, 2024; 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.