Healthcare Provider Details

I. General information

NPI: 1902320294
Provider Name (Legal Business Name): SAISATYA PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2017
Last Update Date: 10/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

G-6061 N SAGINAW RD
MOUNT MORRIS MI
48458-2438
US

IV. Provider business mailing address

3246 LOUIS DR
TROY MI
48083-5040
US

V. Phone/Fax

Practice location:
  • Phone: 810-285-9952
  • Fax: 646-490-9158
Mailing address:
  • Phone: 248-635-4230
  • Fax: 646-490-9158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301011223
License Number StateMI

VIII. Authorized Official

Name: RAMBABU KALAHASTHI
Title or Position: OWNER
Credential: RPH
Phone: 248-635-4230