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NPI Code Detail

MEDICARE: MAHAJAN THERAPEUTICS, LLC

MEDICARE: MAHAJAN THERAPEUTICS, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency586OH

General Provider Information

NPI Number : 1669531810
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAHAJAN THERAPEUTICS, LLC
Provider Business Mailing Address
First Line : 6300 N MAIN ST
Second Line :
City : DAYTON
State : OH
Zip : 45415-3154
Country : US
Telephone Number : 937-275-1500
Fax Number : 937-275-1555
Provider Business Practice Location Address
First Line : 6300 N MAIN ST
Second Line :
City : DAYTON
State : OH
Zip : 45415-3154
Country : US
Telephone Number : 937-275-1500
Fax Number : 937-275-1555
Authorized Official
Title or Position : VP, TREASURER
Name : BRUCE JARVIE
Credential :
Telephone Number : 214-379-3300
Provider Enumeration Date : 12/06/2006
Last Update Date : 07/29/2024

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Directions to “MAHAJAN THERAPEUTICS, LLC ” Practice Location

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