Provider Demographics
NPI:1144231788
Name:DIRECT PHARMACY SERVICES INC
Entity Type:Organization
Organization Name:DIRECT PHARMACY SERVICES INC
Other - Org Name:DIRECT PHARMACY SERVICES INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF VENDOR RELATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CHIULING
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-918-1714
Mailing Address - Street 1:9332 ANNAPOLIS RD
Mailing Address - Street 2:STE 211
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3113
Mailing Address - Country:US
Mailing Address - Phone:301-918-1711
Mailing Address - Fax:301-918-1717
Practice Address - Street 1:6635 W COMMERCIAL BLVD
Practice Address - Street 2:SUITE 116
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33319-2100
Practice Address - Country:US
Practice Address - Phone:954-720-0222
Practice Address - Fax:954-720-0336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD183500000X, 1835G0303X, 1835N0905X, 1835N1003X, 1835P0018X, 1835P1200X, 1835P1300X, 1835X0200X, 333600000X
FLPH220763336C0003X
3336C0004X, 3336L0003X, 3336M0002X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Multi-Specialty
No183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
No1835G0303XPharmacy Service ProvidersPharmacistGeriatricGroup - Multi-Specialty
No1835N0905XPharmacy Service ProvidersPharmacistNuclearGroup - Multi-Specialty
No1835N1003XPharmacy Service ProvidersPharmacistNutrition SupportGroup - Multi-Specialty
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Multi-Specialty
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapyGroup - Multi-Specialty
No1835P1300XPharmacy Service ProvidersPharmacistPsychiatricGroup - Multi-Specialty
No1835X0200XPharmacy Service ProvidersPharmacistOncologyGroup - Multi-Specialty
No333600000XSuppliersPharmacyGroup - Multi-Specialty
No3336C0004XSuppliersPharmacyCompounding PharmacyGroup - Multi-Specialty
No3336L0003XSuppliersPharmacyLong Term Care PharmacyGroup - Multi-Specialty
No3336M0002XSuppliersPharmacyMail Order PharmacyGroup - Multi-Specialty
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP008009737Medicaid
1019909OtherNCPDP PROVIDER IDENTIFICATION NUMBER
MD014010400Medicaid
MIP008009737Medicaid