Provider Demographics
NPI:1396750758
Name:PHARMACY MANAGEMENT SYSTEMS INC
Entity type:Organization
Organization Name:PHARMACY MANAGEMENT SYSTEMS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:PFLEGHAAR
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:989-891-9999
Mailing Address - Street 1:1002 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-7975
Mailing Address - Country:US
Mailing Address - Phone:989-891-9999
Mailing Address - Fax:989-891-9983
Practice Address - Street 1:1002 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-7975
Practice Address - Country:US
Practice Address - Phone:989-891-9999
Practice Address - Fax:989-891-9983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010077733336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2365232Medicaid