Provider Demographics
NPI:1558737759
Name:WESTBROOK, ANDREW EDWARD (PHARM D)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:EDWARD
Last Name:WESTBROOK
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11798 ROUTE 6
Mailing Address - Street 2:
Mailing Address - City:WELLSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16901-6753
Mailing Address - Country:US
Mailing Address - Phone:570-724-6453
Mailing Address - Fax:
Practice Address - Street 1:11798 ROUTE 6
Practice Address - Street 2:
Practice Address - City:WELLSBORO
Practice Address - State:PA
Practice Address - Zip Code:16901-6753
Practice Address - Country:US
Practice Address - Phone:570-724-6453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-11
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY059994183500000X
PARP449213183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist