Organization
MARYMOOR PHARMACY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIDDHARTH VISWANATHAN (MANAGER)
(650) 353-5495
Entity
Organization
Contact information
Practice address
2533 152ND AVE NE STE 14JK, REDMOND, WA 98052-5550
(425) 968-8492
(425) 968-8534
Mailing address
3121 DIABLO AVE, HAYWARD, CA 94545
(650) 353-5495
(650) 435-5932
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
04/22/2021
Last updated
09/29/2022
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