Provider Demographics
NPI:1730783648
Name:TERRAPIN WEST END PHARMACY, LLC
Entity type:Organization
Organization Name:TERRAPIN WEST END PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:FELDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-292-3730
Mailing Address - Street 1:601 CHINQUAPIN ROUND RD
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-4009
Mailing Address - Country:US
Mailing Address - Phone:410-292-3730
Mailing Address - Fax:410-990-4455
Practice Address - Street 1:133 S 17TH ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-6798
Practice Address - Country:US
Practice Address - Phone:601-433-1826
Practice Address - Fax:610-433-0386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy