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Organization

FOWLERVILLE RX LLC

Active
Other names
FOWLERVILLE PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
KRISHNA KANDAGATLA (OWNER)
(517) 223-9832
Entity
Organization

Contact information

Practice address
119 E GRAND RIVER AVE, FOWLERVILLE, MI 48836-5109
(517) 223-9832
Mailing address
119 E GRAND RIVER AVE, FOWLERVILLE, MI 48836-5109
(517) 223-9832

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336L0003X
Long Term Care Pharmacy
Primary

Other

Enumeration date
03/14/2024
Last updated
03/21/2024
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