Healthcare Provider Details

I. General information

NPI: 1255643011
Provider Name (Legal Business Name): GAMA PRESCRIPTION MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2010
Last Update Date: 07/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2234 BAUER RD STE A
BATAVIA OH
45103-1996
US

IV. Provider business mailing address

2234 BAUER RD SUITE A
BATAVIA OH
45103-1996
US

V. Phone/Fax

Practice location:
  • Phone: 513-732-0356
  • Fax: 513-732-0459
Mailing address:
  • Phone: 513-732-0356
  • Fax: 513-732-0459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number022062250
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: BHAVESH PATEL
Title or Position: OWNER,PIC,AO
Credential: RPH
Phone: 513-732-0356