Healthcare Provider Details

I. General information

NPI: 1417320706
Provider Name (Legal Business Name): LAANSA DRUGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2015
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 TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MURALI C GINJUPALLI
Title or Position: PRESIDENT
Credential:
Phone: 989-906-4232