Provider Demographics
NPI:1336664283
Name:US BANGLA CORPORATION
Entity Type:Organization
Organization Name:US BANGLA CORPORATION
Other - Org Name:STAR PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:SHAH
Authorized Official - Middle Name:ALAM
Authorized Official - Last Name:BHUIYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-486-5037
Mailing Address - Street 1:24831 RYAN RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48091-3390
Mailing Address - Country:US
Mailing Address - Phone:248-227-4052
Mailing Address - Fax:586-806-6958
Practice Address - Street 1:24831 RYAN RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48091-3390
Practice Address - Country:US
Practice Address - Phone:586-486-5037
Practice Address - Fax:586-806-6958
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:US BANGLA CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-11
Last Update Date:2017-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy