Organization
MADHAV PHARMACY LLC
Active
Other names
Lakewood Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SRINIVAS SANIKOMMU (MEMBER)
(586) 359-2326
Entity
Organization
Contact information
Practice address
24800 HARPER AVE, SUITE 2, SAINT CLAIR SHORES, MI 48080-1292
(586) 359-2326
(586) 200-2051
Mailing address
24800 HARPER AVE, SUITE 2, SAINT CLAIR SHORES, MI 48080-1292
(586) 359-2326
(586) 200-2051
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301010150
MI
Other
Enumeration date
08/12/2013
Last updated
06/08/2024
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