Organization
JAI SIDDHI VINAYAK INC.
Active
Other names
M L K PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHRADDHA NARENDRA MODI R.PH (PRESIDENT)
(336) 757-0262
Entity
Organization
Contact information
Practice address
1489 NEW WALKERTOWN RD, WINSTON SALEM, NC 27101-3319
(336) 757-0262
Mailing address
1489 NEW WALKERTOWN RD, WINSTON SALEM, NC 27101-3319
(336) 722-0077
(336) 722-0051
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
10479
NC
Other
Enumeration date
02/02/2010
Last updated
09/22/2010
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