Provider Demographics
NPI:1780950253
Name:MEDICATION MANAGEMENT SERVICES INC
Entity type:Organization
Organization Name:MEDICATION MANAGEMENT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:S
Authorized Official - Last Name:FUCHS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:307-638-0300
Mailing Address - Street 1:PO BOX 2476
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82003-2476
Mailing Address - Country:US
Mailing Address - Phone:307-638-0300
Mailing Address - Fax:307-638-0394
Practice Address - Street 1:721 E LINCOLNWAY
Practice Address - Street 2:SUITE 8
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-4703
Practice Address - Country:US
Practice Address - Phone:307-778-7550
Practice Address - Fax:307-432-3801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-28
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY18740.1004363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty