MEDICARE: GAJEWSKI 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	5301009641	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MI6766	OTHER	MI	PROVIDER TRANSACTION ACCESS NUMBER
2	2336914	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1790896983
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GAJEWSKI INC

Provider Business Mailing Address
First Line	:	245 N THIRD ST
Second Line	:
City	:	ROGERS CITY
State	:	MI
Zip	:	49779-1610
Country	:	US
Telephone Number	:	989-734-4701
Fax Number	:	989-734-0991

Provider Business Practice Location Address
First Line	:	245 N THIRD ST
Second Line	:
City	:	ROGERS CITY
State	:	MI
Zip	:	49779-1610
Country	:	US
Telephone Number	:	989-734-4701
Fax Number	:	989-734-0991

Authorized Official
Title or Position	:	PRESIDENT/MANAGER
Name	:	THOMAS GAJEWSKI
Credential	:
Telephone Number	:	989-766-3536

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	01/26/2026

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Directions to “GAJEWSKI INC ” Practice Location

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