Provider Demographics
NPI:1548205032
Name:PHARMACY SERVICES INC.
Entity Type:Organization
Organization Name:PHARMACY SERVICES INC.
Other - Org Name:LARRYS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:HARWORTH
Authorized Official - Last Name:BEALE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:912-283-1151
Mailing Address - Street 1:1710 ALICE ST
Mailing Address - Street 2:
Mailing Address - City:WAYCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:31501-5216
Mailing Address - Country:US
Mailing Address - Phone:912-283-1151
Mailing Address - Fax:912-283-9797
Practice Address - Street 1:1710 ALICE ST
Practice Address - Street 2:
Practice Address - City:WAYCROSS
Practice Address - State:GA
Practice Address - Zip Code:31501-5216
Practice Address - Country:US
Practice Address - Phone:912-283-1151
Practice Address - Fax:912-283-9797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPHRE 0060883336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00030621AMedicaid