Healthcare Provider Details

I. General information

NPI: 1174805543
Provider Name (Legal Business Name): ANULA THURUTHIKKARA RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2011
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date: 06/25/2020
Reactivation Date: 07/01/2020

III. Provider practice location address

37035 S GRATIOT AVE
CLINTON TOWNSHIP MI
48036-2710
US

IV. Provider business mailing address

39590 LAKESHORE DR
HARRISON TOWNSHIP MI
48045
UM

V. Phone/Fax

Practice location:
  • Phone: 586-333-5526
  • Fax: 586-961-6783
Mailing address:
  • Phone: 519-903-5682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302037726
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: