| NPI | 1427381136 |
|---|---|
| Doing Business As | SOUTHGATE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | LATEEF AJANI OLANIYAN Owner/Pharmacist 509-765-9332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: WA PHAR.CF.60118893) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336L0003X Pharmacy Long Term Care Pharmacy | |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2019-10-23 |