1720273428 NPI number — SIRI PHARMACY &MEDICAL EQUIPMENT INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720273428 NPI number — SIRI PHARMACY &MEDICAL EQUIPMENT INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SIRI PHARMACY &MEDICAL EQUIPMENT INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SIRI PHARMACY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720273428
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2969 RIVER VALLEY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TROY
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48098-2394
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-219-0160
Provider Business Mailing Address Fax Number:
248-203-0388

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
418 W HURON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PONTIAC
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48341-1425
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-219-0160
Provider Business Practice Location Address Fax Number:
248-203-0388
Provider Enumeration Date:
09/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ATLURI
Authorized Official First Name:
KHAJENDRANATH
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
248-219-0160

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  5301008684 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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