Srisai RX Mart LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

054014379 Issued in IL

Legal business name

SRISAI RX MART LLC

Doing business as

Leroy Pharmacy

Practice address

304 Sunset Dr
Le Roy, IL 61752-1679

Phone

(309) 962-3627

Fax

(309) 962-3122

NPI assigned

Apr 10, 2014

Last updated

Apr 10, 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

• Leroy Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1397088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397088000000",
    "number": "1861811549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 SUNSET DR",
            "city": "LE ROY",
            "state": "IL",
            "postal_code": "617521679",
            "telephone_number": "309-962-3627",
            "fax_number": "309-962-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 SUNSET DR",
            "city": "LE ROY",
            "state": "IL",
            "postal_code": "617521679",
            "telephone_number": "309-962-3627",
            "fax_number": "309-962-3122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRISAI RX MART LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-10",
        "last_updated": "2014-04-10",
        "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": "IL",
            "license": "054014379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2145186",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Leroy Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patricia Lynn Larkin, M.S., CCC-SLP/L
• Leroy Community School District 2
• Leroy Emergency Ambulance Service Inc
• Kendra McKean, OTR
• Benjamin S Roth
• Srirat Temiyasathit, M.D.
• Jennifer Lynn Thomison, D.T.
• Unlimited Development, Inc. (UDI 4 Leroy Manor)
• Amy Zeleznik, MS CCC SLP/L

• Pharmacy in Le Roy, IL
• Providers in Le Roy, IL by specialty
• Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.