Provider Demographics
NPI:1891077871
Name:VYAS, HIRAL (PHARM D)
Entity Type:Individual
Prefix:
First Name:HIRAL
Middle Name:
Last Name:VYAS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:HIRAL
Other - Middle Name:
Other - Last Name:DESAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:31630 CONCORD DR
Mailing Address - Street 2:APT F
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-1741
Mailing Address - Country:US
Mailing Address - Phone:734-255-0782
Mailing Address - Fax:
Practice Address - Street 1:27750 GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-5911
Practice Address - Country:US
Practice Address - Phone:248-478-4115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302035441183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist