Provider Demographics
NPI:1205987203
Name:LEEWARD ISLANDS APOTHECARIES LLC
Entity type:Organization
Organization Name:LEEWARD ISLANDS APOTHECARIES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TROY
Authorized Official - Middle Name:
Authorized Official - Last Name:DECHABERT SCHUSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:340-642-3141
Mailing Address - Street 1:PO BOX 158
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00821-0158
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4500 SUNNY ISLE SHOPPING CENTER
Practice Address - Street 2:SUITE #41
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820-4493
Practice Address - Country:US
Practice Address - Phone:340-719-6010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI2100400420063336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI1264OtherMAP #
5300405OtherOTHER ID NUMBER-COMMERCIAL NUMBER
5300405OtherOTHER ID NUMBER-COMMERCIAL NUMBER