Organization
SAI RX MART LLC
Active
Other names
The Medicine Shoppe Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SIVA JONNALGADA (MANAGER)
(732) 494-0458
Entity
Organization
Contact information
Practice address
663 E CEDAR AVE, GLADWIN, MI 48624-2215
(989) 426-4595
(989) 426-1993
Mailing address
663 E CEDAR AVE, GLADWIN, MI 48624-2215
(989) 426-4595
(989) 426-1993
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
5301010088
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2140393
PK
—
Enumeration date
11/15/2006
Last updated
07/05/2016
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