Boothwyn Pharmacy Llc
Compounding Pharmacy
221 Gale Ln, Kennett Square
Pennsylvania, 19348-1735
800-476-7496 610-497-4371
Boothwyn Pharmacy Llc is a Compounding Pharmacy in Kennett Square, Pennsylvania. It is located at 221 Gale Ln, Kennett Square and it's customer support contact number is 800-476-7496. The authorized person of Boothwyn Pharmacy Llc is Louis Micolucci who is Owner of the pharmacy and his contact number is 610-485-1130. Active license number of Boothwyn Pharmacy Llc is PP410228L for Compounding Pharmacy in Pennsylvania. Boothwyn Pharmacy Llc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Boothwyn Pharmacy Llc is a pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice.
Pharmacy Details:
Boothwyn Pharmacy Llc type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Boothwyn Pharmacy Llc |
| Type: | Compounding Pharmacy |
| Location: | 221 Gale Ln, Kennett Square,
Pennsylvania, 19348-1735 |
| Phone: | 800-476-7496 |
| Fax: | 610-497-4371 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Louis Micolucci |
| Position: | Owner |
| Contact Number: | 610-485-1130 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1861561714 |
| NPI Enumeration Date: | 07 Nov, 2006 |
| NPI Last Update On: | 20 Mar, 2017 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Boothwyn Pharmacy Llc are as mentioned below.
| Specialization | License Number | State | Status | |
| Compounding Pharmacy | PP410228L | Pennsylvania | Primary | |
| Durable Medical Equipment & Medical Supplies | | | Secondary | |
| Pharmacy | | | Secondary | |
| Community/Retail Pharmacy | | | Secondary | |
| Home Infusion Therapy Pharmacy | | | Secondary | |
| Long Term Care Pharmacy | | | Secondary | |
| Specialty Pharmacy | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 7P228L | Medicaid | South Carolina | |
| 200887500A | Medicaid | Indiana | |
| 2082253 | Other | | Pk |
| 7100087360 | Medicaid | Kentucky | |
| 0936230001 | Medicaid | Nebraska | |
| 0014804650002 | Medicaid | Pennsylvania | |
Medicare Enrollment:
Boothwyn Pharmacy Llc is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 5395865935 | O20131014000397 | Boothwyn Pharmacy Inc | PART B SUPPLIER - MASS IMMUNIZATION (ROSTER BILLER ONLY) |
| 8325323934 | O20170322002154 | Boothwyn Pharmacy Llc | PART B SUPPLIER - OTHER |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 221 Gale Ln,
Kennett Square, Pennsylvania |
| Zip: | 19348 |
| Phone Number: | 800-476-7496 |
| Fax Number: | 610-497-4371 |
Patients can reach Boothwyn Pharmacy Llc at
221 Gale Ln, Kennett Square, Pennsylvania or can
call on customer care at 800-476-7496.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.