Healthcare Provider Details

I. General information

NPI: 1982699971
Provider Name (Legal Business Name): ADVANCED PHARMACY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 02/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

237 S 7TH ST
GRAND JUNCTION CO
81501-3601
US

IV. Provider business mailing address

PO BOX 421
HYDRO OK
73048-0421
US

V. Phone/Fax

Practice location:
  • Phone: 970-242-4484
  • Fax: 970-242-0929
Mailing address:
  • Phone: 405-663-4111
  • Fax: 970-242-0929

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 Number530000023
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

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