Provider Demographics
NPI:1437605326
Name:SPEEDSERVE PHARMACY INC
Entity Type:Organization
Organization Name:SPEEDSERVE PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUBRAMANIAM
Authorized Official - Middle Name:K
Authorized Official - Last Name:RANGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-274-9943
Mailing Address - Street 1:285 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-3430
Mailing Address - Country:US
Mailing Address - Phone:269-274-9943
Mailing Address - Fax:
Practice Address - Street 1:285 NORTH AVE
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-3430
Practice Address - Country:US
Practice Address - Phone:718-938-0263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-30
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010110013336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy