Provider Demographics
NPI:1295572352
Name:EASTERNS PHARMACY LLC
Entity type:Organization
Organization Name:EASTERNS PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RAMA NARASIMHA RAO
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGANTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-622-6094
Mailing Address - Street 1:PO BOX 8201
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-0201
Mailing Address - Country:US
Mailing Address - Phone:509-899-6021
Mailing Address - Fax:
Practice Address - Street 1:801 W DAVIS ST STE 103
Practice Address - Street 2:
Practice Address - City:CLE ELUM
Practice Address - State:WA
Practice Address - Zip Code:98922-1028
Practice Address - Country:US
Practice Address - Phone:509-899-6021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:1
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy