Provider Demographics
NPI:1972508406
Name:SPECIALTY PHARMACY SERVICES, INC
Entity Type:Organization
Organization Name:SPECIALTY PHARMACY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/ VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:D
Authorized Official - Last Name:SWITZLER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:321-953-2004
Mailing Address - Street 1:800 E MELBOURNE AVE
Mailing Address - Street 2:STE B
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-5549
Mailing Address - Country:US
Mailing Address - Phone:321-953-2004
Mailing Address - Fax:321-953-2808
Practice Address - Street 1:800 E MELBOURNE AVE
Practice Address - Street 2:STE B
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-5549
Practice Address - Country:US
Practice Address - Phone:321-953-2004
Practice Address - Fax:321-953-2808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH 14231333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1136240001Medicare ID - Type Unspecified
FL1081037Medicare UPIN