Samy's Drug Store Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHAR.CF.60392660 Issued in WA

Legal business name

SAMY'S DRUG STORE INC.

Doing business as

Samy's Drug Store

Practice address

3525 Ensign Rd NE
Suite H
Olympia, WA 98506-5065

Phone

(360) 878-8174

Fax

(360) 878-8179

NPI assigned

Jul 29, 2013

Organization subpart

No

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

Authorized official

Name

Umesh Gajjala

Title

Owner

Phone

(509) 631-1453

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Samy's Drug Store Doing business as

Medicare fee-for-service enrollment

Enrolled in WA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Samy's Drug Store Inc.

  dba Rochester Pharmacy

  • Community/Retail Pharmacy
  • Rochester, WA
  • NPI 1003584509
  NPPES parent name

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sunil Dulla

  • Pharmacist
  • Tacoma, WA
  • NPI 1891090999
  NPD
• Sai Charan Krovi, PHARM.D

  • Pharmacist
  • Olympia, WA
  • NPI 1023883824
  NPD

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

{
    "created_epoch": "1375056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733702400000",
    "number": "1396187613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 ENSIGN RD NE",
            "address_2": "SUITE H",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065065",
            "telephone_number": "360-878-8174",
            "fax_number": "360-878-8179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 ENSIGN RD NE",
            "address_2": "SUITE H",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065065",
            "telephone_number": "360-878-8174",
            "fax_number": "360-878-8179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMY'S DRUG STORE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-29",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A",
        "authorized_official_last_name": "GAJJALA",
        "authorized_official_first_name": "UMESH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-631-1453"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "PHAR.CF.60392660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2033860",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Samy's Drug Store",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Samy's Drug Store",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Denise Wood Saller, RDH,BA
• Sothear Sam, PHARMD
• John Randall Samples
• Mark S Samson I, MD
• Kapuauluekekai Samuels, L.AC
• Elvia Aurora San Martin
• Marlene Elaine San Nicolas
• Ronald John San Nicolas, PHD, MSW, MHP,
• Miranda Setahrae Sanayei
• Brittany Sanchez-Reed

• Community/Retail Pharmacy in Olympia, WA
• Providers in Olympia, 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 Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.