Provider Demographics
NPI:1104835115
Name:WEST END SERVICES INC
Entity Type:Organization
Organization Name:WEST END SERVICES INC
Other - Org Name:WEST END SERVICES INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:LEON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACY
Authorized Official - Phone:610-437-8850
Mailing Address - Street 1:6620 GRANT WAY
Mailing Address - Street 2:SUITE B
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18106-9316
Mailing Address - Country:US
Mailing Address - Phone:610-437-8850
Mailing Address - Fax:610-437-8852
Practice Address - Street 1:6620 GRANT WAY
Practice Address - Street 2:SUITE B
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18106-9316
Practice Address - Country:US
Practice Address - Phone:610-437-8850
Practice Address - Fax:610-437-8852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336S0011X
PAPP415750L3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2143904OtherPK
PA0018476960001Medicaid
PA0018476960001Medicaid