Pine Lake Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PINE LAKE PHARMACY LLC

Practice address

3042 Issaquah Pine Lake Rd SE
Sammamish, WA 98075-7253

Phone

(425) 944-9444

Fax

(425) 944-9449

NPI assigned

May 14, 2026

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Rama Narasimha Rao Maganti, RPH

Title

Officer

Phone

(469) 406-6588

Specialties & licenses 1

Addresses

Other names 1

• Pine Lake Pharmacy Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1778716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787616000000",
    "number": "1083543458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3042 ISSAQUAH PINE LAKE RD SE",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980757253",
            "telephone_number": "425-944-9444",
            "fax_number": "425-944-9449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3042 ISSAQUAH PINE LAKE RD SE",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "980757253",
            "telephone_number": "425-944-9444",
            "fax_number": "425-944-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE LAKE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-14",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A",
        "authorized_official_last_name": "MAGANTI",
        "authorized_official_first_name": "RAMA NARASIMHA RAO",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "469-406-6588",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pine Lake Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimchi Le Phan, DDS
• Syril B Philip
• Margaret Ann Piela, LMHC, RN
• Kelly Barros Piercy, CB
• Pine Lake Chiropractic Clinic Inc
• Pine Lake Physical Therapy & Sports Rehab, P.S.
• Plateau Chiropractic Clinic
• Plateau Foot and Ankle Clinic PLLC
• Plateau Kids Dentistry, LLC
• David Y Pong, MD

• Community/Retail Pharmacy in Sammamish, WA
• Providers in Sammamish, WA by specialty
• Community/Retail Pharmacy in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.