Provider Demographics
NPI:1891374732
Name:SINGANAMALLA, ROJA RANI
Entity Type:Individual
Prefix:
First Name:ROJA RANI
Middle Name:
Last Name:SINGANAMALLA
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 1:21053 MARSHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48167-2690
Mailing Address - Country:US
Mailing Address - Phone:248-826-3841
Mailing Address - Fax:
Practice Address - Street 1:1019 W SAGINAW ST
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48915-1966
Practice Address - Country:US
Practice Address - Phone:517-374-6103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302413271183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist