Provider Demographics
NPI:1891069282
Name:ANILE PHARMACY INC
Entity Type:Organization
Organization Name:ANILE PHARMACY INC
Other - Org Name:ANILE LONG TERM CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:O-OWNER/RPH
Authorized Official - Prefix:
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ANILE
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:304-723-1818
Mailing Address - Street 1:2413 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-3632
Mailing Address - Country:US
Mailing Address - Phone:304-723-1818
Mailing Address - Fax:304-723-5596
Practice Address - Street 1:2413 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-3632
Practice Address - Country:US
Practice Address - Phone:304-723-1818
Practice Address - Fax:304-723-5596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-02
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
WVSP05524313336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2134130OtherPK