| NPI | 1851143325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRAVEEN ELAMANCHILI Owner/Pharmacist 253-304-0547 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| Enumeration Date | 2024-04-05 |
| Last Update Date | 2024-04-05 |