# WOODSIDE HEALTH SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** WOODSIDE LTC PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639897085
- **Authorized official:** MOHAMED REFAAT AHMED SALEH PHARM.D. (OWNER/MANAGER)
- **Authorized official phone:** (219) 286-3091

## Contact information

- **Practice address:** 1551 STURDY RD, VALPARAISO, IN 46383-7883
- **Practice address phone:** (219) 286-3091
- **Practice address fax:** (219) 510-5268
- **Mailing address:** 1551 STURDY RD, VALPARAISO, IN 46383-7883
- **Mailing address phone:** (219) 286-3091
- **Mailing address fax:** (219) 510-5268

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 08/19/2022
- **Last updated:** 08/22/2022