Organization
SAMY'S DRUG STORE INC.
Active
Other names
Samy's Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
UMESH GAJJALA (OWNER)
(509) 631-1453
Entity
Organization
Contact information
Practice address
3525 ENSIGN RD NE, SUITE H, OLYMPIA, WA 98506-5065
(360) 878-8174
(360) 878-8179
Mailing address
3525 ENSIGN RD NE, SUITE H, OLYMPIA, WA 98506-5065
(360) 878-8174
(360) 878-8179
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHAR.CF.60392660
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2033860
—
WA
Enumeration date
07/29/2013
Last updated
12/09/2024
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