Provider Demographics
NPI:1194523126
Name:CANNERY PHARMACY SERVICES LLC
Entity type:Organization
Organization Name:CANNERY PHARMACY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BESONG
Authorized Official - Last Name:BESONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-423-9052
Mailing Address - Street 1:75 MIRANDA LAMBERT WAY STE 19
Mailing Address - Street 2:
Mailing Address - City:LINDALE
Mailing Address - State:TX
Mailing Address - Zip Code:75771-3107
Mailing Address - Country:US
Mailing Address - Phone:430-235-1000
Mailing Address - Fax:430-235-1000
Practice Address - Street 1:75 MIRANDA LAMBERT WAY STE 19
Practice Address - Street 2:
Practice Address - City:LINDALE
Practice Address - State:TX
Practice Address - Zip Code:75771-3107
Practice Address - Country:US
Practice Address - Phone:430-235-1000
Practice Address - Fax:430-235-1000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy