Provider Demographics
NPI:1285769224
Name:THE APOTHECARY DRUGS INC
Entity type:Organization
Organization Name:THE APOTHECARY DRUGS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHOK
Authorized Official - Middle Name:
Authorized Official - Last Name:EDUPUGANTI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:517-482-0882
Mailing Address - Street 1:737 N GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48906-5160
Mailing Address - Country:US
Mailing Address - Phone:517-482-0882
Mailing Address - Fax:517-482-3234
Practice Address - Street 1:737 N GRAND AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48906-5160
Practice Address - Country:US
Practice Address - Phone:517-482-0882
Practice Address - Fax:517-482-3234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
MI53010084013336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2040935OtherPK
MI2533607Medicaid
MI4886277Medicaid
MI2533607Medicaid