Organization
WEST LAKE PHARMACY INC
Active
Other names
West Lake Pharmacy Inc
Organization subpart
No
Provider details
NPI number
Authorized official
KAMLESH PATEL RPH (OWNER, PRESIDENT)
(732) 841-5085
Entity
Organization
Contact information
Practice address
1828 W LAKE AVE, NEPTUNE, NJ 07753-4663
(732) 455-5885
(732) 455-5882
Mailing address
1828 W LAKE AVE, NEPTUNE, NJ 07753-4663
(732) 455-5885
(732) 455-5882
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28RS00730200
NJ
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0417696
—
NJ
01
—
2130488
PK
—
Enumeration date
02/02/2012
Last updated
08/12/2014
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