Srisiri Pharma Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301010202 Issued in MI

Legal business name

SRISIRI PHARMA INC

Doing business as

Index park Pharmacy

Practice address

2255 Fort St
Index Park Pharmacy
Lincoln Park, MI 48146-2671

Phone

(313) 357-7500

Fax

(313) 347-8998

NPI assigned

Sep 30, 2013

Organization subpart

No

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

Authorized official

Name

Khajendranath Atluri

Title

Agent

Phone

(248) 953-2331

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Index park Pharmacy Doing business as

Tax ID family

Index Meds2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Srisiri Pharma Inc

  • Community/Retail Pharmacy
  • Pontiac, MI
  • NPI 1295029312
  NPD tax ID

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

{
    "created_epoch": "1380499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569369600000",
    "number": "1912334343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 HADSELL DR",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020408",
            "telephone_number": "248-953-2331",
            "fax_number": "313-447-1688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 FORT ST",
            "address_2": "INDEX PARK PHARMACY",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481462671",
            "telephone_number": "313-357-7500",
            "fax_number": "313-347-8998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRISIRI PHARMA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-30",
        "last_updated": "2019-09-25",
        "status": "A",
        "authorized_official_last_name": "ATLURI",
        "authorized_official_first_name": "KHAJENDRANATH",
        "authorized_official_title_or_position": "AGENT",
        "authorized_official_telephone_number": "248-953-2331"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301010202",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2378405",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Index park Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Index park Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Barbara Sorenson
• Jacquie Mary Soulliere, LMSW, CACR
• Sound Hearing Inc.
• Celeste Spight
• Florence Sri-Tharan, M.D.
• Elizabeth Stahl, D.P.M
• Leah Stampfer
• Eve L Stevenson
• Paul Andrew Stewart, LMSW
• Anthony Wayne Stines, DDS

• Community/Retail Pharmacy in Lincoln Park, MI
• Providers in Lincoln Park, 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 Sep 25, 2019; 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.