Southgate Pharmacy Llc
Community/Retail Pharmacy
2709 W Broadway Ave, Moses Lake
Washington, 98837-2904
509-765-9332 509-765-4761
Southgate Pharmacy Llc is a Community/Retail Pharmacy in Moses Lake, Washington. 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 Llc 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 Llc is PHAR.CF.60118893 for Community/Retail Pharmacy in Washington. Southgate Pharmacy Llc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Southgate Pharmacy Llc 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 Llc 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 Llc |
| 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 Llc 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 Llc 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 Llc 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 Llc at
2709 W Broadway Ave, Moses Lake, Washington or can
call on customer care at 509-765-9332.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.