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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