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General NPI Number Information
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NPI Number | 1518041078
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Entity Type | Organization
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Legal Business Name | SANILAC SERVICES INC
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 11/02/2015
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Provider Practice Location Address
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Address Line | 78 S ELK STREET
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City | SANDUSKY
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State | MI
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Zip | 48471-1354
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Country | US
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Telephone | 810-648-2265
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Fax | 810-648-5968
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Provider Business Mailing Address
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Address Line | 78 S ELK STREET
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City | SANDUSKY
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State | MI
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Zip | 48471-1354
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Country | US
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Telephone | 810-648-2265
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Fax | 810-648-5968
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Authorized Official
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Title or Position | CFO
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Name | MRS. AMY RUEDISUELI
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Credential |
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Telephone | 810-648-2265
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301004765
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License Number State | MI
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