Southgate Pharmacy is an authorized DME supplier for medicare equipments and products.
Southgate Pharmacy is a Community/Retail Pharmacy in Moses Lake, Washington. This pharmacy is owned and operated by Southgate Pharmacy Llc. It is located at 2709 W Broadway Ave, Moses Lake and it's customer support contact number is 509-765-9332. The authorized person of Southgate Pharmacy is Mr. Lateef Ajani Olaniyan, PHARM D who is Owner/pharmacist of the pharmacy and his contact number is 509-765-9332. Active license number of Southgate Pharmacy is PHAR.CF.60118893 for Community/Retail Pharmacy in Washington. Southgate Pharmacy accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance. Southgate Pharmacy is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Pharmacy Details:
Southgate Pharmacy type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
Name:
Southgate Pharmacy
Type:
Community/Retail Pharmacy
Location:
2709 W Broadway Ave, Moses Lake, Washington, 98837-2904
Phone:
509-765-9332
Fax:
509-765-4761
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
Name:
Mr. Lateef Ajani Olaniyan
Credentials:
PHARM D
Position:
Owner/pharmacist
Contact Number:
509-765-9332
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
NPI Number:
1427381136
NPI Enumeration Date:
14 Sep, 2009
NPI Last Update On:
23 Oct, 2019
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Southgate Pharmacy are as mentioned below.
Specialization
License Number
State
Status
Community/Retail Pharmacy
PHAR.CF.60118893
Washington
Primary
Pharmacy
Secondary
Long Term Care Pharmacy
Secondary
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
2122066
Other
Pk
6032577
Medicaid
Washington
Medicare Enrollment:
Southgate Pharmacy is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
PAC ID:
Enrollment ID:
Org Name
Medicare Entity Type
6901006295
O20100930055057
Southgate Pharmacy, Llc
DME SUPPLIER - PHARMACY
6901006295
O20101122001253
Southgate Pharmacy, Llc
PART B SUPPLIER - MASS IMMUNIZATION (ROSTER BILLER ONLY)
Products Available:
Southgate Pharmacy has following products available for sale under medicare.
Products
Blood Glucose Monitors & Supplies: Mail Order
Blood Glucose Monitors & Supplies: Non-mail Order
Nebulizer Equipment & Supplies
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
2709 W Broadway Ave, Moses Lake, Washington
Zip:
98837-2904
Phone Number:
509-765-9332
Fax Number:
509-765-4761
Patients can reach Southgate Pharmacy at 2709 W Broadway Ave, Moses Lake, Washington or can call on customer care at 509-765-9332.
Comments/ Reviews:
*Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 March, 2024.
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