Provider Demographics
NPI:1578979290
Name:PRIORITY CARE PHARMACY SERVICES, LLC.
Entity Type:Organization
Organization Name:PRIORITY CARE PHARMACY SERVICES, LLC.
Other - Org Name:PRIORITY CARE PHARMACY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:THARP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-980-1985
Mailing Address - Street 1:1600 HIGHLAND DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:AMORY
Mailing Address - State:MS
Mailing Address - Zip Code:38821-1003
Mailing Address - Country:US
Mailing Address - Phone:888-333-1290
Mailing Address - Fax:877-828-4330
Practice Address - Street 1:1600 HIGHLAND DR STE A
Practice Address - Street 2:
Practice Address - City:AMORY
Practice Address - State:MS
Practice Address - Zip Code:38821-1003
Practice Address - Country:US
Practice Address - Phone:888-333-1290
Practice Address - Fax:877-828-4330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-02
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
MS134493336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2146498OtherPK