Provider Demographics
NPI:1386681369
Name:PHARM SERVICES INC.
Entity Type:Organization
Organization Name:PHARM SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:PUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-887-5004
Mailing Address - Street 1:1510 HIGHWAY 82 E
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:MS
Mailing Address - Zip Code:38751-2339
Mailing Address - Country:US
Mailing Address - Phone:662-887-5004
Mailing Address - Fax:662-887-1002
Practice Address - Street 1:1510 HIGHWAY 82 E
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:MS
Practice Address - Zip Code:38751-2339
Practice Address - Country:US
Practice Address - Phone:662-887-5004
Practice Address - Fax:662-887-1002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSD05311183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00330351Medicaid
MS00330351Medicaid