Srisai RX Mart LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301010291 Issued in MI

Legal business name

SRISAI RX MART LLC

Doing business as

sanford family pharmacy

Practice address

28 W Saginaw Rd
Sanford, MI 48657-9206

Phone

(989) 687-2612

Fax

(989) 687-5596

NPI assigned

Feb 27, 2007

Last updated

Apr 9, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Siva Jonnalgada

Title

Manager

Phone

(732) 494-0458

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• sanford family pharmacy Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397001600000",
    "number": "1013043413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 W SAGINAW RD",
            "city": "SANFORD",
            "state": "MI",
            "postal_code": "486579206",
            "telephone_number": "989-687-2612",
            "fax_number": "989-687-5596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 W SAGINAW RD",
            "city": "SANFORD",
            "state": "MI",
            "postal_code": "486579206",
            "telephone_number": "989-687-2612",
            "fax_number": "989-687-5596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRISAI RX MART LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2014-04-09",
        "status": "A",
        "authorized_official_last_name": "JONNALGADA",
        "authorized_official_first_name": "SIVA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "732-494-0458"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301010291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2143276",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "sanford family pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Trenton Zane Reedy
• Sanford Chiropractic Center PC
• Sanford Medical Center P C
• Elaina Molter Shadrach, MD
• Robert Thomas Smith, DC
• Karen Stephenson
• Corey Tomsich
• Kameron R Toner, RBT
• Stacey Elizabeth Ugartechea, FNP-C
• Paul Michael Wagner

• Community/Retail Pharmacy in Sanford, MI
• Providers in Sanford, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.