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General NPI Number Information
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NPI Number | 1134601842
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Entity Type | Organization
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Legal Business Name | SHRIEEJI INC
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Dates
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Enumeration Date | 08/30/2018
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Last Update Date | 01/30/2020
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Provider Practice Location Address
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Address Line | 1716 W MILHAM AVE
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City | PORTAGE
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State | MI
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Zip | 49024-1230
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Country | US
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Telephone | 269-888-2300
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Fax | 269-993-4749
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Provider Business Mailing Address
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Address Line | 1716 W MILHAM AVE
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City | PORTAGE
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State | MI
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Zip | 49024-1230
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Country | US
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Telephone | 269-888-2300
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Fax | 269-993-4749
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Authorized Official
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Title or Position | MANAGER
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Name | MR. SANJAY G PATEL
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Credential | PHARMACIST
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Telephone | 269-888-2300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 5301011453
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License Number State | MI
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