Healthcare Provider Details

I. General information

NPI: 1487717104
Provider Name (Legal Business Name): CAPE PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 09/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17252 N VILLAGE MAIN BLVD SUITE 3
LEWES DE
19958-6292
US

IV. Provider business mailing address

17252 N VILLAGE MAIN BLVD SUITE 3
LEWES DE
19958-6292
US

V. Phone/Fax

Practice location:
  • Phone: 302-645-0090
  • Fax:
Mailing address:
  • Phone: 302-645-0090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberA30000734
License Number StateDE

VIII. Authorized Official

Name: MR. WILLIAM TRIFILLIS
Title or Position: PHARMACIST-IN-CHARGE
Credential: RPH
Phone: 302-645-0090