Healthcare Provider Details
I. General information
NPI: 1245943141
Provider Name (Legal Business Name): RAMA SATYA PHARMA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/05/2023
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7631 212TH ST SW STE 100
EDMONDS WA
98026-7565
US
IV. Provider business mailing address
6743 WATERTON CIR
MUKILTEO WA
98275-4860
US
V. Phone/Fax
- Phone: 425-977-4880
- Fax: 425-977-4881
- Phone: 425-773-8792
- Fax: 425-977-4881
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
JAI
ARUMILLI
Title or Position: OWNER
Credential:
Phone: 425-773-8792