MEDICARE: GAYATRI PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	023454	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124032545
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GAYATRI PHARMACY INC

Provider Business Mailing Address
First Line	:	2465 UNIVERSITY AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10468-5602
Country	:	US
Telephone Number	:	718-220-4253
Fax Number	:	718-584-6824

Provider Business Practice Location Address
First Line	:	2465 UNIVERSITY AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10468-5602
Country	:	US
Telephone Number	:	718-220-4253
Fax Number	:	718-584-6824

Authorized Official
Title or Position	:	V.P SUPERVISING PHARMACIST
Name	:	MR. DHANESH BHOGILAL SHAH
Credential	:	SUPERVISING-RPH
Telephone Number	:	718-220-4253

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	02/04/2015

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Directions to “GAYATRI PHARMACY INC ” Practice Location

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