1538172499 NPI number — PHARMACY SERVICES INC.

Table of content: (NPI 1538172499)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538172499 NPI number — PHARMACY SERVICES INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
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:
Provider Other Organization Name Type Code:
6
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:
1538172499
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/19/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
228 MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORDWAY
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81063-1403
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
719-267-3544
Provider Business Mailing Address Fax Number:
719-267-4443

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
226 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORDWAY
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81063-1403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-267-3544
Provider Business Practice Location Address Fax Number:
719-267-4443
Provider Enumeration Date:
08/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CASPER
Authorized Official First Name:
SUSAN
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
719-267-3544

Provider Taxonomy Codes

  • Taxonomy code: 332BP3500X , with the licence number:  0347000003 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336L0003X , with the licence number: 960000003 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 03001625 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 960000003 . This is a "STATE PHARMACY LICENSE" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com