Organization
INNOMINDS LLC
Active
Organization
INNOMINDS LLC
Active
Other names
East Valley Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MASTAN RAMPRASAD GANGISETTI RPH (PHARMACY MANAGER)
(509) 942-4835
Entity
Organization
Contact information
Practice address
1215 E WASHINGTON AVE, UNION GAP, WA 98903-1669
(509) 823-1657
(509) 823-1658
Mailing address
PO BOX 8201, YAKIMA, WA 98908-0201
(509) 823-1657
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
01/06/2025
Last updated
01/06/2025
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