Provider Demographics
NPI:1932924321
Name:SELAD CORPORATION
Entity type:Organization
Organization Name:SELAD CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCONNACHIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-635-4000
Mailing Address - Street 1:2985 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARLETTE
Mailing Address - State:MI
Mailing Address - Zip Code:48453-1112
Mailing Address - Country:US
Mailing Address - Phone:989-635-4403
Mailing Address - Fax:
Practice Address - Street 1:2985 MAIN ST
Practice Address - Street 2:
Practice Address - City:MARLETTE
Practice Address - State:MI
Practice Address - Zip Code:48453-1112
Practice Address - Country:US
Practice Address - Phone:989-635-4403
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SELAD CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy