Provider Demographics
NPI:1023002599
Name:WILEY PHARMACY INC
Entity Type:Organization
Organization Name:WILEY PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:W
Authorized Official - Last Name:WILEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS,RPH
Authorized Official - Phone:717-898-8804
Mailing Address - Street 1:903 NISSLEY RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-1472
Mailing Address - Country:US
Mailing Address - Phone:717-898-8804
Mailing Address - Fax:717-898-0048
Practice Address - Street 1:903 NISSLEY RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-1472
Practice Address - Country:US
Practice Address - Phone:717-898-8804
Practice Address - Fax:717-898-0048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-09
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP414663L333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0680250001Medicare NSC