Provider Demographics
NPI:1235371634
Name:BHAGAT, BRIJESH (RPH)
Entity Type:Individual
Prefix:
First Name:BRIJESH
Middle Name:
Last Name:BHAGAT
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 N VAN DYKE RD
Mailing Address - Street 2:RITE AID PHARMACY
Mailing Address - City:ALMONT
Mailing Address - State:MI
Mailing Address - Zip Code:48003-8556
Mailing Address - Country:US
Mailing Address - Phone:810-798-8501
Mailing Address - Fax:810-798-3303
Practice Address - Street 1:860 N VAN DYKE RD
Practice Address - Street 2:RITE AID PHARMACY
Practice Address - City:ALMONT
Practice Address - State:MI
Practice Address - Zip Code:48003-8556
Practice Address - Country:US
Practice Address - Phone:810-798-8501
Practice Address - Fax:810-798-3303
Is Sole Proprietor?:No
Enumeration Date:2009-03-31
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5303035035183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5302035035OtherPHARMACIST LICENCE