Provider Demographics
NPI:1447576822
Name:CHASE PHARMACEUTICAL SERVICES INCORPORATED
Entity Type:Organization
Organization Name:CHASE PHARMACEUTICAL SERVICES INCORPORATED
Other - Org Name:SPECTRUM(RX) CUSTOMIZED PHARMACEUTICALS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/ CEO
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOWDHURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-928-1280
Mailing Address - Street 1:1100 E JASMINE AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-4393
Mailing Address - Country:US
Mailing Address - Phone:956-928-1280
Mailing Address - Fax:888-527-9524
Practice Address - Street 1:1100 E JASMINE AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-4393
Practice Address - Country:US
Practice Address - Phone:956-928-1280
Practice Address - Fax:888-527-9524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-11
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 333600000X
TX268823336C0003X, 3336M0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy
No333600000XSuppliersPharmacy
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148574Medicaid
2124655OtherPK