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Contact Information

SHIVOAM LLC
319 S WOODLAND BLVD
DELAND, FL32720
 Phone: 386-734-3383
 Fax: 386-734-3384
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Compounding Pharmacy

3336C0004X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for SHIVOAM LLC

NPI Number 1134194202
LBN Legal business name SHIVOAM LLC
Authorized official HARDIK SHAH - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/21/2006
Last updated 03/07/2023 - About 3 years ago
Identifiers
FL License # PH11083
FL Medicaid 109020800
Other 1064512 OTHER ID NUMBER-COMMERCIAL NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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