Provider Demographics
NPI:1679872279
Name:AYRE, JOHN E SR (BS PHARMACY)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:E
Last Name:AYRE
Suffix:SR
Gender:M
Credentials:BS PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 GOODRICH ST
Mailing Address - Street 2:
Mailing Address - City:VASSAR
Mailing Address - State:MI
Mailing Address - Zip Code:48768-9205
Mailing Address - Country:US
Mailing Address - Phone:989-823-2391
Mailing Address - Fax:989-823-3332
Practice Address - Street 1:512 GOODRICH ST
Practice Address - Street 2:
Practice Address - City:VASSAR
Practice Address - State:MI
Practice Address - Zip Code:48768-9205
Practice Address - Country:US
Practice Address - Phone:989-823-2391
Practice Address - Fax:989-823-3332
Is Sole Proprietor?:No
Enumeration Date:2011-03-22
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI19568183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI7367213OtherJEARX4151