Healthcare Provider Details

I. General information

NPI: 1861021362
Provider Name (Legal Business Name): WILLEY PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2020
Last Update Date: 01/18/2022
Certification Date: 01/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3625 WRANGLE HILL RD
BEAR DE
19701-1906
US

IV. Provider business mailing address

3625 WRANGLE HILL RD
BEAR DE
19701-1906
US

V. Phone/Fax

Practice location:
  • Phone: 302-353-1050
  • Fax: 302-543-2413
Mailing address:
  • Phone: 302-353-1050
  • Fax: 302-543-2413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. BRANDY WILLEY
Title or Position: OWNER
Credential:
Phone: 302-353-1050