Provider Demographics
NPI:1770990715
Name:PHARMACY MEDICAL SERVICES INC
Entity type:Organization
Organization Name:PHARMACY MEDICAL SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HYRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-641-1448
Mailing Address - Street 1:3850 COCONUT CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33066-1600
Mailing Address - Country:US
Mailing Address - Phone:954-532-6633
Mailing Address - Fax:954-641-1505
Practice Address - Street 1:3850 COCONUT CREEK PKWY
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33066-1600
Practice Address - Country:US
Practice Address - Phone:954-532-6633
Practice Address - Fax:954-641-1505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-22
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH282023336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2146942OtherPK