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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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