Provider Demographics
NPI:1770374118
Name:REDBUD RX PHARMACY
Entity type:Organization
Organization Name:REDBUD RX PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:VENUGOPAL
Authorized Official - Middle Name:R
Authorized Official - Last Name:MAHESHWARAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-974-4985
Mailing Address - Street 1:400 E FRONT ST STE C
Mailing Address - Street 2:
Mailing Address - City:BUCHANAN
Mailing Address - State:MI
Mailing Address - Zip Code:49107-1403
Mailing Address - Country:US
Mailing Address - Phone:269-409-8005
Mailing Address - Fax:
Practice Address - Street 1:400 E FRONT ST STE C
Practice Address - Street 2:
Practice Address - City:BUCHANAN
Practice Address - State:MI
Practice Address - Zip Code:49107-1403
Practice Address - Country:US
Practice Address - Phone:269-409-8005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy