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NPI Code Detail

MEDICARE: MA UMIYA LLC

MEDICARE: MA UMIYA 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
13336C0004XCompounding Pharmacy
23336C0003XCommunity/Retail Pharmacy60006380AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12145056OTHERPK

General Provider Information

NPI Number : 1528479946
Entity Type Code : Organization
Provider Name (Legal Business Name) : MA UMIYA LLC
Provider Business Mailing Address
First Line : 112 N RANDOPH ST
Second Line :
City : GARRETT
State : IN
Zip : 46738
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 112 N RANDOLPH ST
Second Line :
City : GARRETT
State : IN
Zip : 46738-1138
Country : US
Telephone Number : 260-357-0111
Fax Number : 260-357-0122
Authorized Official
Title or Position : MANAGER
Name : BHARAT PATEL
Credential :
Telephone Number : 260-445-6741
Provider Enumeration Date : 05/20/2014
Last Update Date : 05/20/2014

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Directions to “MA UMIYA LLC ” Practice Location

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