Healthcare Provider Details

I. General information

NPI: 1093639700
Provider Name (Legal Business Name): TIGBHA CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 ENGH RD STE A
OMAK WA
98841-9627
US

IV. Provider business mailing address

34 HOPFER RD
OMAK WA
98841-9367
US

V. Phone/Fax

Practice location:
  • Phone: 509-422-1500
  • Fax:
Mailing address:
  • Phone: 509-631-1453
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: UMESH GAJJALA
Title or Position: OWNER/MEMBER
Credential:
Phone: 509-631-1453