Provider Demographics
NPI:1073598280
Name:DRUG SERVICE CARE INC
Entity Type:Organization
Organization Name:DRUG SERVICE CARE INC
Other - Org Name:TUXEDO PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIEBER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:404-255-3022
Mailing Address - Street 1:164 W WIEUCA RD NE
Mailing Address - Street 2:SUITE #7
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-3231
Mailing Address - Country:US
Mailing Address - Phone:404-255-3022
Mailing Address - Fax:404-843-3707
Practice Address - Street 1:164 W WIEUCA RD NE
Practice Address - Street 2:SUITE #7
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-3231
Practice Address - Country:US
Practice Address - Phone:404-255-3022
Practice Address - Fax:404-843-3707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-09
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0131430001Medicare NSC