Provider Demographics
NPI:1417921669
Name:WILLITS PHARMACY SERVICES INC
Entity Type:Organization
Organization Name:WILLITS PHARMACY SERVICES INC
Other - Org Name:WILLITS PHARMACY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DONAHUE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:215-675-7501
Mailing Address - Street 1:21 S YORK RD # 23
Mailing Address - Street 2:
Mailing Address - City:HATBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19040-3231
Mailing Address - Country:US
Mailing Address - Phone:215-675-7501
Mailing Address - Fax:215-675-7590
Practice Address - Street 1:21 S YORK RD # 23
Practice Address - Street 2:
Practice Address - City:HATBORO
Practice Address - State:PA
Practice Address - Zip Code:19040-3231
Practice Address - Country:US
Practice Address - Phone:215-975-7501
Practice Address - Fax:215-675-7590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-15
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP481146333600000X, 3336L0003X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001901674Medicaid
PA001901674Medicaid