Provider Demographics
NPI:1194146241
Name:SEVAN PHARMACY LLC
Entity type:Organization
Organization Name:SEVAN PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDIK
Authorized Official - Middle Name:
Authorized Official - Last Name:SAROYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-478-8679
Mailing Address - Street 1:3188 NE SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98056-3337
Mailing Address - Country:US
Mailing Address - Phone:425-271-6066
Mailing Address - Fax:425-271-6065
Practice Address - Street 1:3188 NE SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98056-3337
Practice Address - Country:US
Practice Address - Phone:425-271-6066
Practice Address - Fax:425-271-6065
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUNSET PLAZA PHARMACY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60151667183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty