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General NPI Number Information
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NPI Number | 1093822249
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Entity Type | Organization
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Legal Business Name | WESTNEDGE MEDICINE INC
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 08/11/2022
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Provider Practice Location Address
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Address Line | 6390 S WESTNEDGE AVE
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City | PORTAGE
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State | MI
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Zip | 49002-3572
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Country | US
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Telephone | 269-327-4508
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Fax | 269-327-6740
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Provider Business Mailing Address
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Address Line | 6390 S WESTNEDGE AVE
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City | PORTAGE
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State | MI
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Zip | 49002-3572
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Country | US
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Telephone | 269-327-4508
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Fax | 269-327-6740
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Authorized Official
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Title or Position | PIC
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Name | JIGAR PATEL
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Credential |
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Telephone | 269-830-0277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 5301006396
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 5301006396
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301006396
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License Number State | MI
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