Organization
SHIVA LLC
Active
Organization
SHIVA LLC
Active
Other names
PROSSER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
UMESH GAJJALA (OWNER/MEMBER)
(509) 631-1453
Entity
Organization
Contact information
Practice address
354 CHARDONNAY AVE STE 5, PROSSER, WA 99350-9545
(509) 788-0123
(509) 788-0124
Mailing address
PO BOX 871, OMAK, WA 98841-0871
(509) 322-7097
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2296040
—
WA
Enumeration date
08/23/2023
Last updated
08/05/2026
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