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Contact Information

FOWLERVILLE RX LLC
119 E GRAND RIVER AVE
FOWLERVILLE, MI48836
 Phone: 517-223-9832
 Fax: 517-223-7267
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for FOWLERVILLE RX LLC

NPI # 1326057308
LBN Legal business name FOWLERVILLE RX LLC
Authorized official KRISHNA KANDAGATLA - (MEMBER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/07/2006
Last updated 11/14/2023 - About 3 years ago
Identifiers
MI License # 5301004232
MI Medicaid 2339100
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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