Organization
LATHRUP APOTHECARY INC
Active
Other names
Lathrup Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ROHINI POTLA (OWNER)
(248) 331-1112
Entity
Organization
Contact information
Practice address
27241 SOUTHFIELD RD, LATHRUP VILLAGE, MI 48076-3406
(248) 331-1112
(248) 331-1114
Mailing address
27241 SOUTHFIELD RD, LATHRUP VILLAGE, MI 48076-3406
(248) 331-1112
(248) 331-1114
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301010578
MI
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2145400
PK
—
Enumeration date
04/15/2014
Last updated
05/25/2016
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