Provider Demographics
NPI:1164710018
Name:ADVANCED PHARMACY SERVICES LLC
Entity Type:Organization
Organization Name:ADVANCED PHARMACY SERVICES LLC
Other - Org Name:ADVANCED PHARMACY SERVICES LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RITTENHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:BSN RN
Authorized Official - Phone:570-208-0277
Mailing Address - Street 1:220 S RIVER ST
Mailing Address - Street 2:
Mailing Address - City:PLAINS
Mailing Address - State:PA
Mailing Address - Zip Code:18705-1137
Mailing Address - Country:US
Mailing Address - Phone:570-208-0277
Mailing Address - Fax:570-208-7201
Practice Address - Street 1:220 S RIVER ST
Practice Address - Street 2:
Practice Address - City:PLAINS
Practice Address - State:PA
Practice Address - Zip Code:18705-1137
Practice Address - Country:US
Practice Address - Phone:570-208-0277
Practice Address - Fax:570-208-7201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-13
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL054.017764332B00000X
FLPH25678333600000X
KYPA15063336C0003X
NJ28RO000714003336C0004X
PAPP4821473336H0001X
3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102633660 0001Medicaid
2131151OtherPK
6708270001Medicare NSC