=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205263183
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ASCENT MEDS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/08/2013
-----------------------------------------------------
Last Update Date | 06/29/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6224 DIXIE HWY
-----------------------------------------------------
City | BRIDGEPORT
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48722-9513
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 989-777-2900
-----------------------------------------------------
Fax | 989-777-4649
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6224 DIXIE HWY 6224 DIXIE HWY
-----------------------------------------------------
City | BRIDGEPORT
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48722-9513
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | PINAL PATEL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 989-777-2900
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 5301010288
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------