Provider Demographics
NPI:1760715841
Name:INSTITUTIONAL PHARMACY SOLUTIONS, LLC
Entity Type:Organization
Organization Name:INSTITUTIONAL PHARMACY SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO & SENIOR VP OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:KRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:MIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-356-7627
Mailing Address - Street 1:400 INTERSTATE PARK DR
Mailing Address - Street 2:SUITE 430
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36109-5428
Mailing Address - Country:US
Mailing Address - Phone:334-356-7627
Mailing Address - Fax:334-356-8347
Practice Address - Street 1:192 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-7238
Practice Address - Country:US
Practice Address - Phone:910-577-1400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-08
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103553336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy