Provider Demographics
NPI:1730463845
Name:BACHIREDDY, SRILAKSHMI
Entity Type:Individual
Prefix:
First Name:SRILAKSHMI
Middle Name:
Last Name:BACHIREDDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2445 ANDOVER BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48306-4937
Mailing Address - Country:US
Mailing Address - Phone:248-635-6268
Mailing Address - Fax:
Practice Address - Street 1:2445 ANDOVER BLVD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48306-4937
Practice Address - Country:US
Practice Address - Phone:248-635-6268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-07
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302035138183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist