Provider Demographics
NPI:1508476896
Name:WESTBROOK PHARMACY, LLC
Entity Type:Organization
Organization Name:WESTBROOK PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTBROOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-774-2201
Mailing Address - Street 1:17340 QUAKER LN
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20860-1247
Mailing Address - Country:US
Mailing Address - Phone:301-774-2201
Mailing Address - Fax:301-774-2202
Practice Address - Street 1:17340 QUAKER LN
Practice Address - Street 2:
Practice Address - City:SANDY SPRING
Practice Address - State:MD
Practice Address - Zip Code:20860-1247
Practice Address - Country:US
Practice Address - Phone:301-774-2201
Practice Address - Fax:301-774-2202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-03
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy