Healthcare Provider Details

I. General information

NPI: 1659390730
Provider Name (Legal Business Name): LAANSA DRUGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 01/30/2022
Certification Date: 01/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 N JOHNSON ST
BAY CITY MI
48708-6250
US

IV. Provider business mailing address

920 N JOHNSON ST
BAY CITY MI
48708-6250
US

V. Phone/Fax

Practice location:
  • Phone: 989-892-4531
  • Fax: 989-892-0946
Mailing address:
  • Phone: 989-892-4531
  • Fax: 989-892-0946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301005017
License Number StateMI

VIII. Authorized Official

Name: MR. MURALI CHAND GINJUPALLI
Title or Position: VICE PRESIDENT
Credential: R.PH
Phone: 989-892-4531