Jai Siddhi Vinayak Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

10479 Issued in NC

Legal business name

JAI SIDDHI VINAYAK INC.

Practice address

1489 New Walkertown Rd
Winston Salem, NC 27101-3319

Phone

(336) 757-0262

NPI assigned

Feb 2, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Shraddha Narendra Modi, R.PHNPI 1497698567

Title

President

Phone

(336) 757-0262

Specialties & licenses 1

Addresses

Other names 1

• M L K PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shraddha Modi

  • Pharmacist
  • Lexington, NC
  • NPI 1497698567
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1265068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285113600000",
    "number": "1407188451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1489 NEW WALKERTOWN RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271013319",
            "telephone_number": "336-722-0077",
            "fax_number": "336-722-0051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1489 NEW WALKERTOWN RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271013319",
            "telephone_number": "336-757-0262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAI SIDDHI VINAYAK INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-02",
        "last_updated": "2010-09-22",
        "status": "A",
        "authorized_official_last_name": "MODI",
        "authorized_official_first_name": "SHRADDHA",
        "authorized_official_middle_name": "NARENDRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-757-0262",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.PH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "10479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "M L K PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimura Garcia Chermez'S Jacobs, PA-C
• Traci Jacobs, PHARM.D
• Mary E Jacobsen, PSY.D.
• Leslie Sue Jacobson, MD
• Darius A. Jahann, M.D.
• Jai Siddhi Vinayak Inc.
• Jaime E Trujillo MD PA
• Vasudha Jain, MD
• Vernika Jain, MS, EDS, LCMHCA, NC
• Ashish Jairath, M.D.

• Community/Retail Pharmacy in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2010; 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.

Verify at the official NPI Registry.