Provider Demographics
NPI:1013043223
Name:PHARMACY SERVICES INC
Entity Type:Organization
Organization Name:PHARMACY SERVICES INC
Other - Org Name:ORDWAY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COOL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:719-267-3411
Mailing Address - Street 1:228 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ORDWAY
Mailing Address - State:CO
Mailing Address - Zip Code:81063-1403
Mailing Address - Country:US
Mailing Address - Phone:719-267-3411
Mailing Address - Fax:719-267-3468
Practice Address - Street 1:228 MAIN ST
Practice Address - Street 2:
Practice Address - City:ORDWAY
Practice Address - State:CO
Practice Address - Zip Code:81063-1403
Practice Address - Country:US
Practice Address - Phone:719-267-3411
Practice Address - Fax:719-267-3468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-24
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO960000002333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO03630225Medicaid
CO0605468OtherNABP#