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General NPI Number Information
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NPI Number | 1871625004
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Entity Type | Organization
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Legal Business Name | SIDDHI CORP
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11664 MARTIN RD
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City | WARREN
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State | MI
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Zip | 48093-4511
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Country | US
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Telephone | 586-756-2500
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Fax | 586-756-2572
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Provider Business Mailing Address
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Address Line | PO BOX 87140
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City | CANTON
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State | MI
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Zip | 48187
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JYOTSNABEN PATEL
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Credential |
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Telephone | 313-412-9220
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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 | 5301008590
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License Number State | MI
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