Provider Demographics
NPI:1417652694
Name:CWIKLA, LE MAI (PHARMD)
Entity Type:Individual
Prefix:
First Name:LE MAI
Middle Name:
Last Name:CWIKLA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 KRIEBEL MILL RD
Mailing Address - Street 2:
Mailing Address - City:EAGLEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19403-1044
Mailing Address - Country:US
Mailing Address - Phone:717-880-5686
Mailing Address - Fax:
Practice Address - Street 1:2540 METROPOLITAN DR STE 2546
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-6738
Practice Address - Country:US
Practice Address - Phone:215-880-0917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP447708183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist