Provider Demographics
NPI:1700423639
Name:EASTERNS PHARMACY LLC
Entity Type:Organization
Organization Name:EASTERNS PHARMACY LLC
Other - Org Name:EASTERNS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
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:RPH
Authorized Official - Phone:469-406-6588
Mailing Address - Street 1:515 MINOR AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2138
Mailing Address - Country:US
Mailing Address - Phone:206-662-6094
Mailing Address - Fax:206-662-3667
Practice Address - Street 1:515 MINOR AVE STE 120
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2138
Practice Address - Country:US
Practice Address - Phone:206-662-6094
Practice Address - Fax:206-664-3667
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EASTERNS PHARMACY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-10
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy