Provider Demographics
NPI:1619976446
Name:IHS ACQUISITION XXX, INC.
Entity Type:Organization
Organization Name:IHS ACQUISITION XXX, INC.
Other - Org Name:US BIOSERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:RATLIFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-365-8202
Mailing Address - Street 1:3101 GAYLORD PKWY
Mailing Address - Street 2:MAILSTOP 1E-E144
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-8655
Mailing Address - Country:US
Mailing Address - Phone:469-365-8129
Mailing Address - Fax:469-365-8274
Practice Address - Street 1:109 CHELSEA PKWY
Practice Address - Street 2:
Practice Address - City:BOOTHWYN
Practice Address - State:PA
Practice Address - Zip Code:19061-1305
Practice Address - Country:US
Practice Address - Phone:800-400-9549
Practice Address - Fax:469-365-8274
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:APS ENTERPRISES HOLDING CO., INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-14
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP413902L333600000X, 3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016822280005Medicaid
PA1197750005Medicare NSC