Provider Demographics
NPI:1033457205
Name:SBK PHARMA LLC
Entity Type:Organization
Organization Name:SBK PHARMA LLC
Other - Org Name:FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:HARIKRISHNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAJJA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, PHD
Authorized Official - Phone:425-778-7778
Mailing Address - Street 1:7315 212TH ST SW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-7610
Mailing Address - Country:US
Mailing Address - Phone:425-778-7778
Mailing Address - Fax:425-778-7888
Practice Address - Street 1:7315 212TH ST SW
Practice Address - Street 2:SUITE 100
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7610
Practice Address - Country:US
Practice Address - Phone:425-778-7778
Practice Address - Fax:425-778-7888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPHAR.CF.603377073336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FF3804552OtherDEA LICENSE