Provider Demographics
NPI:1073570255
Name:PHARMSERV INC
Entity Type:Organization
Organization Name:PHARMSERV INC
Other - Org Name:PHARMSERV INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT, PIC
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUI
Authorized Official - Suffix:
Authorized Official - Credentials:BS PHARMACY
Authorized Official - Phone:713-988-0883
Mailing Address - Street 1:6828 RANCHESTER DR
Mailing Address - Street 2:STE A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-4541
Mailing Address - Country:US
Mailing Address - Phone:713-988-0883
Mailing Address - Fax:713-774-2700
Practice Address - Street 1:6828 RANCHESTER DR
Practice Address - Street 2:STE A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-4541
Practice Address - Country:US
Practice Address - Phone:713-988-0883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-30
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 333600000X
TX214373336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4431990001Medicare NSC
2096827OtherPK
TX148122Medicaid