Provider Demographics
NPI:1568863397
Name:WEST CECIL PHARMACY
Entity Type:Organization
Organization Name:WEST CECIL PHARMACY
Other - Org Name:WEST CECIL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HEMIL
Authorized Official - Middle Name:
Authorized Official - Last Name:KHANDWALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-865-6577
Mailing Address - Street 1:49 ROCK SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:CONOWINGO
Mailing Address - State:MD
Mailing Address - Zip Code:21918-1352
Mailing Address - Country:US
Mailing Address - Phone:443-731-2988
Mailing Address - Fax:410-378-2331
Practice Address - Street 1:49 ROCK SPRINGS RD
Practice Address - Street 2:
Practice Address - City:CONOWINGO
Practice Address - State:MD
Practice Address - Zip Code:21918-1352
Practice Address - Country:US
Practice Address - Phone:443-731-2988
Practice Address - Fax:410-378-2331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-11
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP064853336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2147931OtherPK