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General NPI Number Information
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NPI Number | 1366501504
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Entity Type | Organization
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Legal Business Name | OM SHRI CORPORATION
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 09/02/2009
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Provider Practice Location Address
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Address Line | 6002 N LAPEER RD
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City | NORTH BRANCH
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State | MI
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Zip | 48461-9730
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Country | US
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Telephone | 810-793-5006
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Fax | 810-793-5101
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Provider Business Mailing Address
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Address Line | 6002 N LAPEER RD
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City | NORTH BRANCH
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State | MI
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Zip | 48461-9730
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Country | US
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Telephone | 810-793-5006
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Fax | 810-793-5101
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Authorized Official
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Title or Position | OFFICER
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Name | MR. NUTAN MOTICHAND SHAH
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Credential | R PH
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Telephone | 810-793-5006
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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 | 5301007648
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License Number State | MI
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