Provider Demographics
NPI:1083634604
Name:PROFESSIONAL PHARMACY SERVICES, INC.
Entity Type:Organization
Organization Name:PROFESSIONAL PHARMACY SERVICES, INC.
Other - Org Name:GOOD DAY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:EINHELLIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-461-1975
Mailing Address - Street 1:2121 E HARMONY RD UNIT 135
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-3401
Mailing Address - Country:US
Mailing Address - Phone:970-204-9111
Mailing Address - Fax:970-223-3375
Practice Address - Street 1:2121 E HARMONY RD UNIT 135
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-3401
Practice Address - Country:US
Practice Address - Phone:970-204-9111
Practice Address - Fax:970-223-3375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO92172334Medicaid
CO0517830006Medicare NSC