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General NPI Number Information
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NPI Number | 1477970903
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Entity Type | Organization
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Legal Business Name | JAY GAYATRI INC
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Dates
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Enumeration Date | 03/21/2014
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Last Update Date | 05/14/2015
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Provider Practice Location Address
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Address Line | 2405 E 14 MILE RD
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City | STERLING HEIGHTS
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State | MI
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Zip | 48310-5961
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Country | US
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Telephone | 586-439-3550
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Fax | 586-646-2584
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Provider Business Mailing Address
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Address Line | 380 ASHLAWN CT
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City | TROY
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State | MI
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Zip | 48083-6500
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Country | US
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Telephone | 586-439-3550
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Fax | 586-646-2584
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Authorized Official
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Title or Position | MANAGER/PIC
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Name | KANAIYALAL PATEL
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Credential | RPH
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Telephone | 586-439-3550
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301010432
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License Number State | MI
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