Provider Demographics
NPI:1881693646
Name:I H S ACQUISTION XXX, INC
Entity type:Organization
Organization Name:I H S ACQUISTION XXX, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VACANT
Authorized Official - Middle Name:
Authorized Official - Last Name:VACANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-400-9549
Mailing Address - Street 1:309 HENDERSON DR
Mailing Address - Street 2:
Mailing Address - City:SHARON HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19079-1034
Mailing Address - Country:US
Mailing Address - Phone:800-400-9549
Mailing Address - Fax:610-586-5509
Practice Address - Street 1:3110 POLARIS AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-8359
Practice Address - Country:US
Practice Address - Phone:702-876-0056
Practice Address - Fax:702-876-4559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPH01751333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV28021221Medicaid
NV1197750012Medicare NSC