Provider Demographics
NPI:1053696633
Name:AMIN, HIRENKUMAR
Entity type:Individual
Prefix:
First Name:HIRENKUMAR
Middle Name:
Last Name:AMIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4241 HASTINGS DR
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-7310
Mailing Address - Country:US
Mailing Address - Phone:267-804-2353
Mailing Address - Fax:
Practice Address - Street 1:1509 S STATE RD STE F
Practice Address - Street 2:
Practice Address - City:DAVISON
Practice Address - State:MI
Practice Address - Zip Code:48423-1966
Practice Address - Country:US
Practice Address - Phone:810-412-4666
Practice Address - Fax:810-496-2605
Is Sole Proprietor?:No
Enumeration Date:2011-10-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302037765183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist