Provider Demographics
NPI:1619662210
Name:AAYRA HEALTHCARE LLC
Entity Type:Organization
Organization Name:AAYRA HEALTHCARE LLC
Other - Org Name:HOPKINVILLE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MAULIK
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:270-632-6180
Mailing Address - Street 1:495 NORTH DR
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-1884
Mailing Address - Country:US
Mailing Address - Phone:270-632-6180
Mailing Address - Fax:270-632-6181
Practice Address - Street 1:495 NORTH DR
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-1884
Practice Address - Country:US
Practice Address - Phone:270-632-6180
Practice Address - Fax:270-632-6181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-10
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100895400Medicaid