Provider Demographics
NPI:1134798556
Name:LW PHARMACEUTICALS INC
Entity type:Organization
Organization Name:LW PHARMACEUTICALS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SHAREHOLDER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:BLAKE
Authorized Official - Last Name:MUSICK
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:276-591-7035
Mailing Address - Street 1:288 LAUREL CYN
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-4726
Mailing Address - Country:US
Mailing Address - Phone:276-591-7035
Mailing Address - Fax:
Practice Address - Street 1:1325 BONHAM RD
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:VA
Practice Address - Zip Code:24202-6012
Practice Address - Country:US
Practice Address - Phone:276-285-3390
Practice Address - Fax:276-285-3391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy