| NPI | 1790631778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SRINIVASULU MANDAVA Pharmacy Manager 509-899-6021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2026-03-10 |
| Last Update Date | 2026-03-10 |