Active NPI
Shrieeji Inc
Doing business as milham pharmacy
- Pharmacy
- Portage, MI
National Provider Identifier
1134601842
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 5301011453
- Legal business name
- SHRIEEJI INC
- Doing business as
- milham pharmacy
- Practice address
- 1716 W Milham Ave
Portage, MI 49024-1230 - Phone
- (269) 888-2300
- Fax
- (269) 993-4749
- NPI assigned
- Aug 30, 2018
- Last updated
- Jan 30, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Sanjay G Patel, PHARMACIST
- Title
- Manager
- Phone
- (269) 888-2300
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 5301011453 | MI | Primary |
Addresses
Primary practice location
1716 W Milham Ave
Portage, MI 49024-1230
Mailing address
1716 W Milham Ave
Portage, MI 49024-1230
Phone (269) 888-2300
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5301011453 | Other | MI | MICHIGAN PHARMACY LICENSE |
| 5315095380 | Other | MI | MICHIGAN CONTROL SUBSTANCE LICENSE |
Other names 1
- milham pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20181220000512 | MI | Part B Supplier - Pharmacy | 4082959010 | Practice locations: Portage, MI |
| O20210323001619 | MI | Part B Supplier - Independent Clinical Laboratory | 4082959010 | Practice locations: Portage, MI |
National Provider Directory
National Provider DirectoryLocations
1716 W Milham Ave
Portage, MI 49024
Phone (269) 861-6518
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pharmacist
- Portage, MI
- NPI 1235723800
-
- Pharmacist
- Portage, MI
- NPI 1417549148
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535587200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1580342400000",
"number": "1134601842",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1716 W MILHAM AVE",
"city": "PORTAGE",
"state": "MI",
"postal_code": "490241230",
"telephone_number": "269-888-2300",
"fax_number": "269-993-4749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1716 W MILHAM AVE",
"city": "PORTAGE",
"state": "MI",
"postal_code": "490241230",
"telephone_number": "269-888-2300",
"fax_number": "269-993-4749"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHRIEEJI INC",
"organizational_subpart": "NO",
"enumeration_date": "2018-08-30",
"last_updated": "2020-01-30",
"certification_date": "2020-01-30",
"status": "A",
"authorized_official_last_name": "PATEL",
"authorized_official_first_name": "SANJAY",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "269-888-2300",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "PHARMACIST"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "MI",
"license": "5301011453",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MICHIGAN PHARMACY LICENSE",
"identifier": "5301011453",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MICHIGAN CONTROL SUBSTANCE LICENSE",
"identifier": "5315095380",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "milham pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Portage, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.