Provider Demographics
NPI:1497085971
Name:NORTHWEST PHARMACY INC
Entity Type:Organization
Organization Name:NORTHWEST PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VOLHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRSHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-683-7787
Mailing Address - Street 1:6819 REISTERSTOWN RD
Mailing Address - Street 2:STE 207A
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-1418
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6819 REISTERSTOWN RD
Practice Address - Street 2:STE 207A
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-1418
Practice Address - Country:US
Practice Address - Phone:443-683-7787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDPW0331333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy