Organization
SRI KRISHNAIAH CORPORATION
Active
Organization
SRI KRISHNAIAH CORPORATION
Active
Other names
SPANAWAY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
PRAVEEN ELAMANCHILI (MANAGER)
(253) 847-2781
Entity
Organization
Contact information
Practice address
17701 PACIFIC AVE S STE D2, SPANAWAY, WA 98387-4609
(253) 847-2781
(253) 847-6664
Mailing address
17701 PACIFIC AVE S, SUITE D2, SPANAWAY, WA 98387-4609
(253) 847-2781
(253) 847-6664
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHARCF60583990
WA
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2153425
PK
—
Enumeration date
08/11/2015
Last updated
02/18/2025
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