Healthcare Provider Details

I. General information

NPI: 1982938940
Provider Name (Legal Business Name): TLBAY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2009
Last Update Date: 03/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 S EUCLID AVE
BAY CITY MI
48706-3271
US

IV. Provider business mailing address

615 S EUCLID AVE
BAY CITY MI
48706-3271
US

V. Phone/Fax

Practice location:
  • Phone: 989-671-9684
  • Fax: 989-671-9685
Mailing address:
  • Phone: 989-671-9684
  • Fax: 989-671-9685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301009199
License Number StateMI

VIII. Authorized Official

Name: JANMEJAY VYAS
Title or Position: PRESIDENT
Credential:
Phone: 989-671-9684