Provider Demographics
NPI:1992015853
Name:MAKALI INC
Entity Type:Organization
Organization Name:MAKALI INC
Other - Org Name:BEECHER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAMUBAHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-785-0402
Mailing Address - Street 1:G-6061 N SAGINAW ST
Mailing Address - Street 2:
Mailing Address - City:MT. MORRIS
Mailing Address - State:MI
Mailing Address - Zip Code:48458
Mailing Address - Country:US
Mailing Address - Phone:810-785-0402
Mailing Address - Fax:810-785-0409
Practice Address - Street 1:G-6061 N SAGINAW ST
Practice Address - Street 2:
Practice Address - City:MT. MORRIS
Practice Address - State:MI
Practice Address - Zip Code:48458
Practice Address - Country:US
Practice Address - Phone:810-785-0402
Practice Address - Fax:810-785-0409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-13
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010094253336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2374647OtherNCPDP PROVIDER IDENTIFICATION NUMBER