PROSSER SOUTHGATE PHARMACY INC (NPI# 1700417854) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700417854 |
| Entity Type | Organization |
| Organization Name | PROSSER SOUTHGATE PHARMACY INC |
| Practice Address |
207 Canyon Drive Prosser WA 99350-1009 |
| Mailing Address |
2709 W. Broadway Avenue Moses Lake WA 98837 |
| Practice Telephone | 5097508319 |
| Practice Fax Number | 5097654761 |
| Mailing Telephone | 5097508319 |
| Mailing Fax Number | 5097654761 |
| Enumeration Date | 2020-01-28 |
| Last Update Date | 2020-01-28 |
| Authorized Official Name | LATEEF A. OLANIYAN (PRESIDENT) |
| Authorized Official Telephone | 5097508319 |
| Authorized Official Credential | RPH, PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| Prosser Southgate Pharmacy | Doing Business As Name - Organization |
| Street Address |
207 CANYON DRIVE |
| City | PROSSER |
| State | WA |
| Zip Code | 99350-1009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801272182 | Shopko Stores Operating Co., LLC | Durable Medical Equipment & Medical Supplies | 471 Wine Country Road, Prosser, WA 99350 | 2015-08-10 |
| 1083091466 | Sarah Min | Pediatrics | Prosser Clinic-prosser Memorial Health, 336 Chardonnay Ave Suite A, Prosser, WA 99350 | 2015-05-05 |
| 1174939805 | Kiranmayi Korimerla | Family Medicine | 336 Chardinnay Ave #a, Kadlec Clinic Prosser Primary Care, Prosser, WA 99350 | 2014-07-02 |
| 1427478965 | Dzmitry Zhmurouski | Internal Medicine | 336 Chardonnay Ave., Suite A, Prosser, WA 99350 | 2014-04-23 |
| 1972920080 | David Carl | Pediatrics | Benton City Clinic-prosser Memorial Health, 701 Dale Ave Suite A, Benton City, WA 99350 | 2014-03-26 |
| 1619310554 | Weslee Chew | Surgery | Prosser Specialty Clinic-prosser Memorial Health, 820 Memorial Street Suite 3, Prosser, WA 99350 | 2013-04-10 |
| 1871844894 | Teresa Renee Charvet | Physician Assistant | 336 Chardonnay Ave Bldg 3, Prosser, WA 99350 | 2012-10-01 |
| 1376894048 | Walla Walla General Hospital | Clinic/Center | 336 Chardonnay Ave Ste A, Prosser, WA 99350 | 2012-09-21 |
| 1902162274 | Nicole Deanne Denny | Speech-Language Pathologist | 326 Chardonnay Blvd, Prosser Physical Therapy and Rehab, Prosser, WA 99350 | 2012-04-11 |
| 1386934461 | Brian G Sollers | Obstetrics & Gynecology | 336 Chardonnay Ave, Bldg 3, Prosser, WA 99350 | 2011-04-11 |
| Find all providers in zip 99350 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073170296 | Shiva LLC | Pharmacy | 354 Chardonnay Ave Ste 5, Prosser, WA 99350-9545 | 2019-05-22 |
| 1306469580 | Benton Southgate Pharmacy Inc | Pharmacy | 471 Wine Country Road, Prosser, WA 99350 | 2020-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700493533 | Doctors Pharmacy, LLC | Pharmacy | 65 Columbia Point Dr, Richland, WA 99352-4375 | 2020-09-25 |
| 1871105999 | Whidbey Island Public Hospital District | Pharmacy | 7 Ne Birch St, Coupeville, WA 98239-3132 | 2020-08-19 |
| 1710504550 | Kayshuv Enterprises | Pharmacy | 7505 Sandifur Pkwy, Suite 102, Pasco, WA 99301 | 2020-06-27 |
| 1811511454 | Kaiser Foundation Health Plan of Washington | Pharmacy | 189 Telegraph Rd, Bellingham, WA 98226-8079 | 2020-05-29 |
| 1548883630 | Capsule Seattle LLC | Pharmacy | 2033 6th Ave Ste 120, Seattle, WA 98121-2526 | 2020-05-22 |
| 1063048197 | Peninsula Pharmacies Inc Long Beach Pharmacy Annex | Pharmacy | 110 Oregon Ave S, Long Beach, WA 98631 | 2020-03-20 |
| 1174155345 | Kaiser Foundation Health Plan of Washington | Pharmacy | 2335 172nd Street Ne, Marysville, WA 98271 | 2020-02-06 |
| 1245861996 | Salish Integrative Medicine, Inc | Pharmacy | 3700 Pacific Hwy E Ste 100b, Fife, WA 98424-1160 | 2020-01-31 |
| 1700423639 | Venkateswara LLC | Pharmacy | 515 Minor Ave Ste 120, Seattle, WA 98104-2138 | 2019-12-10 |
| 1548807738 | Kaiser Foundation Health Plan of Washington | Pharmacy | 1200 Cooper Point Road Sw, Suite 100, Olympia, WA 98502 | 2019-12-06 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PROSSER SOUTHGATE PHARMACY INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.