Provider Demographics
NPI:1225561046
Name:RIDGETOP PHARMACY LLC
Entity Type:Organization
Organization Name:RIDGETOP PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:INDRAJEETSINH
Authorized Official - Middle Name:
Authorized Official - Last Name:SARVAIYA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:206-319-3468
Mailing Address - Street 1:9414 RIDGETOP BLVD NW STE 104
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8526
Mailing Address - Country:US
Mailing Address - Phone:360-633-7066
Mailing Address - Fax:360-633-7026
Practice Address - Street 1:9414 RIDGETOP BLVD NW STE 104
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8526
Practice Address - Country:US
Practice Address - Phone:360-633-7066
Practice Address - Fax:360-633-7026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-08
Last Update Date:2017-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPHAR.CF.607384223336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy