Provider Demographics
NPI:1659897114
Name:WESTMORELAND PHARMACY, INC.
Entity type:Organization
Organization Name:WESTMORELAND PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:WESTMORELAND
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:502-298-9085
Mailing Address - Street 1:7600 HIGHWAY 60 STE 400
Mailing Address - Street 2:
Mailing Address - City:SELLERSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47172-1935
Mailing Address - Country:US
Mailing Address - Phone:812-461-0025
Mailing Address - Fax:812-461-0026
Practice Address - Street 1:7600 HIGHWAY 60 STE 400
Practice Address - Street 2:
Practice Address - City:SELLERSBURG
Practice Address - State:IN
Practice Address - Zip Code:47172
Practice Address - Country:US
Practice Address - Phone:812-461-0025
Practice Address - Fax:812-461-0026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-16
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN60006623A333600000X, 3336C0004X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100535450Medicaid
IN300003899Medicaid
IN60006623AOtherLICENSE NUMBER