Sai RX Mart LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

5301010088 Issued in MI

Legal business name

SAI RX MART LLC

Practice address

663 E Cedar Ave
Gladwin, MI 48624-2215

Phone

(989) 426-4595

Fax

(989) 426-1993

NPI assigned

Nov 15, 2006

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

• The Medicine Shoppe Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467676800000",
    "number": "1396817185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "663 E CEDAR AVE",
            "city": "GLADWIN",
            "state": "MI",
            "postal_code": "486242215",
            "telephone_number": "989-426-4595",
            "fax_number": "989-426-1993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "663 E CEDAR AVE",
            "city": "GLADWIN",
            "state": "MI",
            "postal_code": "486242215",
            "telephone_number": "989-426-4595",
            "fax_number": "989-426-1993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAI RX MART LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2016-07-05",
        "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": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MI",
            "license": "5301010088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2140393",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Medicine Shoppe Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dawn Marie Rosas, CPRC
• Evan Noel Rubenacker-O'Dell
• Maria Johanna Ruffer
• Tyler Alan Ruhle
• Nancy Rutterbush
• Ashley Nicole Samalik
• Brianna Sasse
• Albert Peter Sawaya, D.C.
• Faith Schell
• Tiffany Schmidt

• Pharmacy in Gladwin, MI
• Providers in Gladwin, MI by specialty
• Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2016; 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.