Provider Demographics
NPI:1326622168
Name:WOOSTER PHARMACY LLC
Entity Type:Organization
Organization Name:WOOSTER PHARMACY LLC
Other - Org Name:HEIDI'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:MS
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GEIB
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:330-465-0979
Mailing Address - Street 1:3431 COMMERCE PKWY STE D
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-7114
Mailing Address - Country:US
Mailing Address - Phone:330-439-5139
Mailing Address - Fax:330-439-4453
Practice Address - Street 1:3431 COMMERCE PKWY STE D
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-7114
Practice Address - Country:US
Practice Address - Phone:330-439-5139
Practice Address - Fax:330-439-4453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-07
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy