Provider Demographics
NPI:1497991269
Name:GALAXY PHARMACY INC
Entity Type:Organization
Organization Name:GALAXY PHARMACY INC
Other - Org Name:GALAXY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:RAMPRAKASH
Authorized Official - Middle Name:
Authorized Official - Last Name:NARAYANKUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-765-3681
Mailing Address - Street 1:33100 W 12 MILE RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3307
Mailing Address - Country:US
Mailing Address - Phone:248-987-6500
Mailing Address - Fax:248-987-6502
Practice Address - Street 1:33100 W 12 MILE RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3307
Practice Address - Country:US
Practice Address - Phone:248-987-6500
Practice Address - Fax:248-987-6502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-30
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010090143336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2372287OtherNCPDP PROVIDER IDENTIFICATION NUMBER