Provider Demographics
NPI:1942211594
Name:PHARMACY SOLUTIONS INC
Entity Type:Organization
Organization Name:PHARMACY SOLUTIONS INC
Other - Org Name:PHARMACY SOLUTIONS INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:920-794-1225
Mailing Address - Street 1:1516 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:TWO RIVERS
Mailing Address - State:WI
Mailing Address - Zip Code:54241-3045
Mailing Address - Country:US
Mailing Address - Phone:920-553-1225
Mailing Address - Fax:
Practice Address - Street 1:1516 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:TWO RIVERS
Practice Address - State:WI
Practice Address - Zip Code:54241-3045
Practice Address - Country:US
Practice Address - Phone:920-553-1225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI85710423336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5129261OtherNCPDP PROVIDER IDENTIFICATION NUMBER