Provider Demographics
NPI:1982911442
Name:JRK PHARMA INC
Entity type:Organization
Organization Name:JRK PHARMA INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAIKRISHNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARUMILLI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:425-346-2148
Mailing Address - Street 1:21701 76TH AVE W
Mailing Address - Street 2:STE 104 A
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-7536
Mailing Address - Country:US
Mailing Address - Phone:425-346-2148
Mailing Address - Fax:425-977-4881
Practice Address - Street 1:21701 76TH AVE W
Practice Address - Street 2:STE 104 A
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7536
Practice Address - Country:US
Practice Address - Phone:425-346-2148
Practice Address - Fax:425-977-4881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-04
Last Update Date:2010-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPHAR.CF.60180646261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center