Healthcare Provider Details
I. General information
NPI: 1205987203
Provider Name (Legal Business Name): LEEWARD ISLANDS APOTHECARIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/16/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4500 SUNNY ISLE SHOPPING CENTER SUITE #41
CHRISTIANSTED VI
00820-4493
US
IV. Provider business mailing address
PO BOX 158
CHRISTIANSTED VI
00821-0158
US
V. Phone/Fax
- Phone: 340-719-6010
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 210040042006 |
| License Number State | VI |
VIII. Authorized Official
Name:
TROY
DECHABERT SCHUSTER
Title or Position: MANAGING MEMBER
Credential:
Phone: 340-642-3141