Provider Demographics
NPI:1043658016
Name:OM-SAI INC
Entity Type:Organization
Organization Name:OM-SAI INC
Other - Org Name:FLUSHING DISCOUNT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:
Authorized Official - First Name:ASHESH
Authorized Official - Middle Name:
Authorized Official - Last Name:MODI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:810-487-9361
Mailing Address - Street 1:6390 W PIERSON RD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:MI
Mailing Address - Zip Code:48433-2300
Mailing Address - Country:US
Mailing Address - Phone:810-487-9361
Mailing Address - Fax:810-487-9362
Practice Address - Street 1:6390 W PIERSON RD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:MI
Practice Address - Zip Code:48433-2300
Practice Address - Country:US
Practice Address - Phone:810-487-9361
Practice Address - Fax:810-487-9362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-12
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336S0011X
MI53010101203336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1043658016Medicaid
2140508OtherPK