Pavan Putra Investment Group LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE010307 Issued in GA

Legal business name

PAVAN PUTRA INVESTMENT GROUP LLC

Practice address

111 Canal St Ste 101
Pooler, GA 31322-4054

Phone

(912) 999-6101

Fax

(912) 777-5953

NPI assigned

Aug 21, 2016

Organization subpart

No

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

Authorized official

Name

Dhruminkumar PatelNPI 1548926389

Title

Pic/RPH/Coowner

Phone

(912) 988-7185

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Apollo Pharmacy #2 Doing business as

Medicare fee-for-service enrollment

Enrolled in GA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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

• Dhruminkumar Patel

  • Pharmacist
  • Pooler, GA
  • NPI 1548926389
  NPD Authorized official
• Kaushal Patel, RPH

  • Pharmacist
  • Savannah, GA
  • NPI 1508455973
  NPD

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

{
    "created_epoch": "1471737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690243200000",
    "number": "1932654860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CANAL ST STE 101",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224054",
            "telephone_number": "912-999-6101",
            "fax_number": "912-777-5953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CANAL ST STE 101",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224054",
            "telephone_number": "912-999-6101",
            "fax_number": "912-777-5953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAVAN PUTRA INVESTMENT GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-21",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "DHRUMINKUMAR",
        "authorized_official_title_or_position": "PIC/RPH/COOWNER",
        "authorized_official_telephone_number": "912-988-7185"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE010307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2163745",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Apollo Pharmacy #2",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Apollo Pharmacy #2",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sandipkumar I. Patel
• Shital Patel, M.D.
• Trupti Patel
• Kelly Paul, CCC-SLP
• Kasharia Paulk
• Adelphy Payero, OD
• Preston Lloyd Peacock, DC
• Pedsnow LLC
• Peeples Health and Wellness
• Corey D Peeples, FNP

• Community/Retail Pharmacy in Pooler, GA
• Providers in Pooler, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.