Provider Demographics
NPI:1356363436
Name:ONCOLOGY PHARMACY SERVICES, INC
Entity type:Organization
Organization Name:ONCOLOGY PHARMACY SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:J
Authorized Official - Middle Name:ERNEST
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-490-2912
Mailing Address - Street 1:PO BOX 731145
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-1145
Mailing Address - Country:US
Mailing Address - Phone:972-997-8103
Mailing Address - Fax:469-467-2535
Practice Address - Street 1:1400 N 4TH ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-4756
Practice Address - Country:US
Practice Address - Phone:903-234-7060
Practice Address - Fax:903-757-9283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19967332B00000X, 333600000X
3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX119783201Medicaid
TX19967OtherCLASS A LICENSE
TX320208OtherTX VENDOR DRUG
TX4589428OtherNCPDP
TX1324470009Medicare NSC