Provider Demographics
NPI:1275635690
Name:SAI PHARMACY LLC
Entity Type:Organization
Organization Name:SAI PHARMACY LLC
Other - Org Name:WRIGHTS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAKSHMI
Authorized Official - Middle Name:
Authorized Official - Last Name:KALLURU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-789-4834
Mailing Address - Street 1:147 W SAGINAW ST
Mailing Address - Street 2:
Mailing Address - City:HEMLOCK
Mailing Address - State:MI
Mailing Address - Zip Code:48626-9541
Mailing Address - Country:US
Mailing Address - Phone:989-642-5411
Mailing Address - Fax:989-642-5967
Practice Address - Street 1:147 W SAGINAW ST
Practice Address - Street 2:
Practice Address - City:HEMLOCK
Practice Address - State:MI
Practice Address - Zip Code:48626-9541
Practice Address - Country:US
Practice Address - Phone:989-642-5411
Practice Address - Fax:989-642-5967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
MI53010107753336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1275635690Medicaid
2154280OtherPK