Healthcare Provider Details

I. General information

NPI: 1174193932
Provider Name (Legal Business Name): BLENKELL ANTWI BAAH-WILLIAMS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2021
Last Update Date: 07/26/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 ROCKLAND ST
READING PA
19604-1501
US

IV. Provider business mailing address

19B FRIEDEN MNR
SCHUYLKILL HAVEN PA
17972-9507
US

V. Phone/Fax

Practice location:
  • Phone: 610-988-4838
  • Fax:
Mailing address:
  • Phone: 347-636-3908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP455020
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: