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NPI 1366140501

NPI 1366140501 : WEST FIRST AVE PHARMACY LLC : TOPPENISH, WA

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General NPI Number Information
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    NPI Number           |    1366140501
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    Entity Type          |    Organization 
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    Legal Business Name  |    WEST FIRST AVE PHARMACY LLC 
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Dates
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    Enumeration Date     |    02/17/2023
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    Last Update Date     |    02/19/2023
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Provider Practice Location Address
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    Address Line         |    802 W 1ST AVE STE 100 
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    City                 |    TOPPENISH
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    State                |    WA
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    Zip                  |    98948-1164
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    Country              |    US
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    Telephone            |    509-400-4200
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1715 W KENNEWICK AVE 
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    City                 |    KENNEWICK
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    State                |    WA
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    Zip                  |    99336-3378
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    Country              |    US
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    Telephone            |    509-400-4500
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |     REDDY  ANNAPPAREDDY 
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    Credential           |    
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    Telephone            |    509-841-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    3336C0003X
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    Taxonomy Name        |    Community/Retail Pharmacy
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    License Number       |    
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    License Number State |    
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