Provider Demographics
NPI:1740232651
Name:WESTFALL, LARRY (RPH, PHARMD)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:
Last Name:WESTFALL
Suffix:
Gender:M
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 S. ATLANTIC AVE.
Mailing Address - Street 2:UNIT #20405
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32169
Mailing Address - Country:US
Mailing Address - Phone:610-518-7298
Mailing Address - Fax:610-518-7297
Practice Address - Street 1:5300 S. ATLANTIC AVE.
Practice Address - Street 2:UNIT #20405
Practice Address - City:NEW SMYRNA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32169
Practice Address - Country:US
Practice Address - Phone:610-518-7298
Practice Address - Fax:610-518-7297
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP4394581835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy