Provider Demographics
NPI:1891055430
Name:ACCESS PHARMACY INC
Entity Type:Organization
Organization Name:ACCESS PHARMACY INC
Other - Org Name:ACCESS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER,PIC,AO
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:SEWPERSAD
Authorized Official - Suffix:
Authorized Official - Credentials:BSC PHARMACY
Authorized Official - Phone:206-246-0040
Mailing Address - Street 1:17833 1ST AVE S STE C
Mailing Address - Street 2:
Mailing Address - City:NORMANDY PARK
Mailing Address - State:WA
Mailing Address - Zip Code:98148-1713
Mailing Address - Country:US
Mailing Address - Phone:206-246-0040
Mailing Address - Fax:206-246-0070
Practice Address - Street 1:17833 1ST AVE S STE C
Practice Address - Street 2:
Practice Address - City:NORMANDY PARK
Practice Address - State:WA
Practice Address - Zip Code:98148-1713
Practice Address - Country:US
Practice Address - Phone:206-246-0040
Practice Address - Fax:206-246-0070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-16
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
WAPHAR.CF.602824423336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2017903Medicaid
2135263OtherPK