Organization
CENTRAL PHARMACY - MLK LLC
Active
Organization
CENTRAL PHARMACY - MLK LLC
Active
Other names
Central Pharmacy - MLK
Organization subpart
No
Provider details
NPI number
Authorized official
KRISHNA KANDAGATLA (OWNER)
(517) 992-5101
Entity
Organization
Contact information
Practice address
3500 S MLK BLVD, LANSING, MI 48910-4339
(517) 574-5015
(517) 574-5362
Mailing address
3500 S MLK BLVD, LANSING, MI 48910-4339
(517) 574-5362
(517) 574-5362
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301010726
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2154108
PK
—
05
—
2381060
—
MI
Enumeration date
09/21/2015
Last updated
11/14/2023
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