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NPI 1770031874

NPI 1770031874 : UMA PARVATI LLC : NILES, MI

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General NPI Number Information
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    NPI Number           |    1770031874
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    Entity Type          |    Organization 
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    Legal Business Name  |    UMA PARVATI LLC 
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Dates
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    Enumeration Date     |    09/17/2016
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    Last Update Date     |    09/19/2025
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Provider Practice Location Address
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    Address Line         |    70 E MAIN ST 
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    City                 |    NILES
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    State                |    MI
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    Zip                  |    49120-2200
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    Country              |    US
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    Telephone            |    269-262-4343
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    Fax                  |    269-262-0930
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Provider Business Mailing Address
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    Address Line         |    70 E MAIN ST 
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    City                 |    NILES
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    State                |    MI
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    Zip                  |    49120
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    Country              |    US
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    Telephone            |    269-262-4343
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    Fax                  |    269-262-0930
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Authorized Official
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    Title or Position    |    PHARMACY IN CHARGE
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    Name                 |     SANDIPKUMAR  PATEL 
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    Credential           |    
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    Telephone            |    224-595-7209
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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       |    
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    License Number State |    
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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       |    
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    License Number State |    
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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       |    5301011020
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    License Number State |    MI
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