Prosser Southgate Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PROSSER SOUTHGATE PHARMACY INC

Practice address

207 Canyon Drive
Prosser, WA 99350-1009

Phone

(509) 750-8319

Fax

(509) 765-4761

NPI assigned

Jan 28, 2020

Organization subpart

No

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

Authorized official

Name

Lateef A. Olaniyan, RPH, PHARMD

Title

President

Phone

(509) 750-8319

Specialties & licenses 1

Addresses

Other names 1

• Prosser Southgate Pharmacy Doing business as

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

{
    "created_epoch": "1580169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580169600000",
    "number": "1700417854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 W. BROADWAY AVENUE",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "98837",
            "telephone_number": "509-750-8319",
            "fax_number": "509-765-4761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 CANYON DRIVE",
            "city": "PROSSER",
            "state": "WA",
            "postal_code": "993501009",
            "telephone_number": "509-750-8319",
            "fax_number": "509-765-4761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSSER SOUTHGATE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-28",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A",
        "authorized_official_last_name": "OLANIYAN",
        "authorized_official_first_name": "LATEEF",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-750-8319",
        "authorized_official_credential": "RPH, PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prosser Southgate Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Prosser Public Hospital District of Benton County
• Prosser Public Hospital District of Benton County
• Prosser Public Hospital District of Benton County
• Prosser Public Hospital District of Benton County
• Prosser School District
• Jerri Purdy
• Barbara Lynda Ramirez-Kantman, LMP, CMA, CCT
• James William Rasey, LMT
• Matthew James Rasey, LMT
• Rebecca Reinhard

• Community/Retail Pharmacy in Prosser, WA
• Providers in Prosser, 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 Jan 28, 2020; 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.