Organization
SIYAA HEALTHCARE LLC
Active
Organization
SIYAA HEALTHCARE LLC
Active
Other names
Tiny Town Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAULIK PATEL PHARMD (OFFICER)
(000) 000-0000
Entity
Organization
Contact information
Practice address
1790 TINY TOWN RD STE B, CLARKSVILLE, TN 37042-7636
(931) 378-6292
(931) 378-6293
Mailing address
1790 TINY TOWN RD STE B, CLARKSVILLE, TN 37042-7636
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q070836
—
TN
Enumeration date
10/29/2021
Last updated
03/25/2022
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