Provider Demographics
NPI:1255695540
Name:TRIPATHI, BHAVIK (RPH)
Entity type:Individual
Prefix:
First Name:BHAVIK
Middle Name:
Last Name:TRIPATHI
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 1:33689 PONDVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-1471
Mailing Address - Country:US
Mailing Address - Phone:248-231-1028
Mailing Address - Fax:
Practice Address - Street 1:33689 PONDVIEW CIR
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-1471
Practice Address - Country:US
Practice Address - Phone:248-231-1028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-02
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302031526183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist