Provider Demographics
NPI:1114926961
Name:PHARM PLUS ACQUISITION INC
Entity Type:Organization
Organization Name:PHARM PLUS ACQUISITION INC
Other - Org Name:US BIOSERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. CONSULTANT PAYER RELATIONS
Authorized Official - Prefix:
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:L
Authorized Official - Last Name:CAMPA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-799-4174
Mailing Address - Street 1:5025 PLANO PKWY
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-5022
Mailing Address - Country:US
Mailing Address - Phone:469-365-8287
Mailing Address - Fax:844-811-7689
Practice Address - Street 1:5100 E HUNTER AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-2049
Practice Address - Country:US
Practice Address - Phone:800-801-1140
Practice Address - Fax:469-365-8274
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:APS ENTERPRISES HOLDING CO., INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-14
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46321333600000X, 3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA463210Medicaid
CAPHA463210Medicaid