MEDICARE: GAYATRIMATA LLC

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

General Provider Information

NPI Number	:	1407574882
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GAYATRIMATA LLC

Provider Business Mailing Address
First Line	:	2670 KENSINGTON PARK TRL NW
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37312-2298
Country	:	US
Telephone Number	:	423-740-4788
Fax Number	:	423-740-4789

Provider Business Practice Location Address
First Line	:	2296 DALTON PIKE SE
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37311-7752
Country	:	US
Telephone Number	:	423-650-3605
Fax Number	:

Authorized Official
Title or Position	:	PHARMACY OWNER
Name	:	METESH JAYANTILAL PATEL
Credential	:
Telephone Number	:	423-650-3605

Provider Enumeration Date	:	08/22/2022
Last Update Date	:	03/10/2026

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Directions to “GAYATRIMATA LLC ” Practice Location

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