PINE LAKE PHARMACY
NPI 1083543458
Pharmacy - Community/Retail Pharmacy in Sammamish, WA

NPI Status: Active since May 14, 2026

Contact Information

3042 ISSAQUAH PINE LAKE RD SE
SAMMAMISH, WA
ZIP 98075
Phone: (425) 944-9444
Fax: (425) 944-9449

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  • Organization
  • Pharmacy
  • Community/Retail Pharmacy
  • CLIA Number: 50D2272628
  • CLIA Cert. Type: Other - AFH
  • CLIA Exp. Date: 04-04-2028

About PINE LAKE PHARMACY

This page provides the complete NPI Profile along with additional information for Pine Lake Pharmacy, a provider established in Sammamish, Washington operating as a Pharmacy, focusing in community/retail pharmacy . The healthcare provider is registered in the NPI registry with number 1083543458 assigned on May 2026. The practitioner's primary taxonomy code is 3336C0003X. The provider is registered as an organization and their NPI record was last updated May 2026. The authorized official of this NPI record is Mr. Rama Narasimha Rao Maganti Rph (Officer)

NPI
1083543458
Provider Name
PINE LAKE PHARMACY
Entity Type
Organization
Location Address
3042 ISSAQUAH PINE LAKE RD SE SAMMAMISH, WA 98075
Location Phone
(425) 944-9444
Location Fax
(425) 944-9449
Mailing Address
3042 ISSAQUAH PINE LAKE RD SE SAMMAMISH, WA 98075
Mailing Phone
(425) 944-9444
Mailing Fax
(425) 944-9449
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-14-2026
Last Update Date
05-14-2026
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pharmacy Community/Retail Pharmacy

Taxonomy Code
3336C0003X
Type
Suppliers
Taxonomy Description
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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. RAMA NARASIMHA RAO MAGANTI RPH

Authorized Official Title
OFFICER
Authorized Official Phone
(469) 406-6588

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
50D2272628
Facility Type
Other - AFH
Certificate Effective Date
November 23, 2022
Certificate Expiration Date
April 04, 2028
Laboratory Director
VIORICA POP
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Pine Lake Pharmacy to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1083543458, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 52. The final step is to find the difference between that total and the next multiple of ten (60 - 52 = 8).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
3
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
4
Unchanged
Pos 7
3
Doubled → 6
Pos 8
4
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
8
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 8 → 16 → 7 5 → 10 → 1 3 → 6 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 1 + 6 + 3 + 1 + 0 + 4 + 6 + 4 + 1 + 0 + 24 = 52

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 52 is 60. The difference is the calculated check digit.

60 - 52 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1083543458.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Optometrist
3042 ISSAQUAH PINE LAKE RD SE
SAMMAMISH, WA 98075
Optometrist
3042 ISSAQUAH PINE LAKE RD SE
SAMMAMISH, WA 98075

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1083543458, enumerated as an "organization" on May 14, 2026.

The provider is located at 3042 ISSAQUAH PINE LAKE RD SE SAMMAMISH, WA 98075 and the phone number is (425) 944-9444.

Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.