Healthcare Provider Details

I. General information

NPI: 1831119452
Provider Name (Legal Business Name): PROFESSIONAL PHARMACY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 06/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 S ELM
EATON CO
80615-3128
US

IV. Provider business mailing address

3780 E 15TH ST SUITE 102
LOVELAND CO
80538-8766
US

V. Phone/Fax

Practice location:
  • Phone: 970-454-2110
  • Fax: 970-454-1943
Mailing address:
  • Phone: 970-461-1975
  • Fax: 970-461-4042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: VICKI EINHELLIG
Title or Position: PRESIDENT
Credential: RPH
Phone: 970-461-1975