Provider Demographics
NPI:1730102724
Name:ASSOCIATED PHARMACY SERVICES INC
Entity Type:Organization
Organization Name:ASSOCIATED PHARMACY SERVICES INC
Other - Org Name:PSA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:828-686-3804
Mailing Address - Street 1:2294 AND 1/2 US HIGHWAY 70
Mailing Address - Street 2:
Mailing Address - City:SWANNANOA
Mailing Address - State:NC
Mailing Address - Zip Code:28778
Mailing Address - Country:US
Mailing Address - Phone:828-686-3804
Mailing Address - Fax:828-686-3839
Practice Address - Street 1:2294 AND 1/2 US HIGHWAY 70
Practice Address - Street 2:
Practice Address - City:SWANNANOA
Practice Address - State:NC
Practice Address - Zip Code:28778
Practice Address - Country:US
Practice Address - Phone:828-686-3804
Practice Address - Fax:828-686-3839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X
NC092353336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0115683Medicaid
2065740OtherPK
NC0115683Medicaid