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NPI Code Detail

MEDICARE: ADINARAYANA ANDY

MEDICARE:   ADINARAYANA  ANDY
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
1183500000XPharmacist5302042414MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15302042414OTHERMIPHARMACIST LICENSE NUMBER

General Provider Information

NPI Number : 1437514957
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADINARAYANA ANDY
Provider Business Mailing Address
First Line : 210 HINCKLEY BLVD
Second Line :
City : JACKSON
State : MI
Zip : 49203-5313
Country : US
Telephone Number : 517-784-3184
Fax Number : 517-784-2202
Provider Business Practice Location Address
First Line : 210 HINCKLEY BLVD
Second Line :
City : JACKSON
State : MI
Zip : 49203-5313
Country : US
Telephone Number : 517-784-3184
Fax Number : 517-784-2202
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2015
Last Update Date : 12/28/2015

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Directions to “ ADINARAYANA ANDY ” Practice Location

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