Provider Demographics
NPI:1851925895
Name:MALLI INC
Entity Type:Organization
Organization Name:MALLI INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LAKSHMI
Authorized Official - Middle Name:V
Authorized Official - Last Name:SRIHARSHA BINGI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-250-1786
Mailing Address - Street 1:501 E OLIVE AVE
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95380-4012
Mailing Address - Country:US
Mailing Address - Phone:209-250-1786
Mailing Address - Fax:209-250-2815
Practice Address - Street 1:501 E OLIVE AVE
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-4012
Practice Address - Country:US
Practice Address - Phone:209-250-1786
Practice Address - Fax:209-250-1786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-28
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy