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General NPI Number Information
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NPI Number | 1174550404
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Entity Type | Organization
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Legal Business Name | JAI CHAMUNDA MILLER INC
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 04/09/2018
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Provider Practice Location Address
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Address Line | 206 N BROADWAY ST
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City | UNION CITY
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State | MI
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Zip | 49094-1154
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Country | US
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Telephone | 517-741-3604
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Fax | 517-741-7812
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Provider Business Mailing Address
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Address Line | 206 N BROADWAY ST
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City | UNION CITY
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State | MI
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Zip | 49094-1154
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Country | US
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Telephone | 517-741-3604
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Fax | 517-741-7812
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Authorized Official
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Title or Position | PRESIDENT
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Name | BHAVESH B PATEL
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Credential |
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Telephone | 517-741-3604
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301004334
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License Number State | MI
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