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General NPI Number Information
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NPI Number | 1437678141
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Entity Type | Organization
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Legal Business Name | HASLETT PHARMACY LLC
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Dates
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Enumeration Date | 09/13/2017
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Last Update Date | 11/14/2023
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Provider Practice Location Address
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Address Line | 1620 HASLETT RD STE B
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City | HASLETT
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State | MI
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Zip | 48840-8457
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Country | US
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Telephone | 517-339-0300
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Fax | 517-339-0333
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Provider Business Mailing Address
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Address Line | 1620 HASLETT RD STE B
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City | HASLETT
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State | MI
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Zip | 48840-8457
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Country | US
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Telephone | 517-339-0300
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Fax | 517-339-0333
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Authorized Official
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Title or Position | OWNER
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Name | KRISHNA KANDAGATLA
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Credential |
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Telephone | 517-992-5101
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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 | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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