Provider Demographics
NPI:1154512051
Name:DEMSKI, JAY MICHAEL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:MICHAEL
Last Name:DEMSKI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48158-8748
Mailing Address - Country:US
Mailing Address - Phone:734-428-8393
Mailing Address - Fax:734-428-0731
Practice Address - Street 1:128 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48158-8748
Practice Address - Country:US
Practice Address - Phone:734-428-8393
Practice Address - Fax:734-428-0731
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302035115183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist