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General NPI Number Information
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NPI Number | 1275612855
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Entity Type | Organization
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Legal Business Name | SHASAM DRUGS PC
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 01/30/2022
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Provider Practice Location Address
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Address Line | 8501 MAIN ST
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City | BIRCH RUN
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State | MI
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Zip | 48415-7734
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Country | US
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Telephone | 989-624-9231
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Fax | 989-624-4093
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Provider Business Mailing Address
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Address Line | 8501 MAIN ST
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City | BIRCH RUN
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State | MI
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Zip | 48415-7734
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Country | US
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Telephone | 989-624-9231
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Fax | 989-624-4093
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Authorized Official
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Title or Position | PRESIDENT
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Name | MURALI GINJUPALLI
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Credential |
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Telephone | 989-624-9231
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301010658
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License Number State | MI
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