Healthcare Provider Details

I. General information

NPI: 1912193343
Provider Name (Legal Business Name): ADVANCED PHARMACY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2007
Last Update Date: 02/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4605 QUEBEC ST STE B-11
DENVER CO
80216-3405
US

IV. Provider business mailing address

PO BOX 421
HYDRO OK
73048-0421
US

V. Phone/Fax

Practice location:
  • Phone: 303-592-2000
  • Fax: 405-663-4114
Mailing address:
  • Phone: 405-663-4111
  • Fax: 405-663-4114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number666
License Number StateCO

VIII. Authorized Official

Name: KENT ABBOTT
Title or Position: MANAGER
Credential:
Phone: 405-663-4111