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Organization

VPST CORPORATION

Active
Other names
SPANAWAY PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
PRAVEEN ELAMANCHILI RPH (OWNER/PHARMACIST)
(253) 304-0547
Entity
Organization

Contact information

Practice address
15711 PACIFIC AVE S, TACOMA, WA 98444-4675
(253) 304-0547
Mailing address
15711 PACIFIC AVE S, TACOMA, WA 98444-4675

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
3336C0004X
Compounding Pharmacy
3336L0003X
Long Term Care Pharmacy

Other

Enumeration date
04/05/2024
Last updated
01/29/2025
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