Organization
BENTON SOUTHGATE PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LATEEF AJANI OLANIYAN PHARM. D (PRESIDENT)
(509) 750-8319
Entity
Organization
Contact information
Practice address
471 WINE COUNTRY ROAD, PROSSER, WA 99350
(509) 781-6520
(509) 781-6523
Mailing address
471 WINE COUNTRY ROAD, PROSSER, WA 99350
(509) 750-8319
(509) 765-4761
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
05/22/2020
Last updated
07/14/2021
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