1144231788 NPI number — DIRECT PHARMACY SERVICES INC

Table of content: (NPI 1144231788)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144231788 NPI number — DIRECT PHARMACY SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DIRECT PHARMACY SERVICES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
DIRECT PHARMACY SERVICES INC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144231788
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/22/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9332 ANNAPOLIS RD
Provider Second Line Business Mailing Address:
STE 211
Provider Business Mailing Address City Name:
LANHAM
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20706-3113
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-918-1711
Provider Business Mailing Address Fax Number:
301-918-1717

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6635 W COMMERCIAL BLVD
Provider Second Line Business Practice Location Address:
SUITE 116
Provider Business Practice Location Address City Name:
TAMARAC
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33319-2100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-720-0222
Provider Business Practice Location Address Fax Number:
954-720-0336
Provider Enumeration Date:
08/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WANG
Authorized Official First Name:
CHIULING
Authorized Official Middle Name:
Authorized Official Title or Position:
VP OF VENDOR RELATIONS
Authorized Official Telephone Number:
301-918-1714

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1835G0303X , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1835N0905X , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1835N1003X , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1835P0018X , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1835P1200X , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1835P1300X , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1835X0200X , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 333600000X , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336C0003X , with the licence number: PH22076 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336C0004X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336L0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336M0002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336S0011X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P008009737 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1019909 . This is a "NCPDP PROVIDER IDENTIFICATION NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 014010400 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




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