Healthcare Provider Details

I. General information

NPI: 1093704132
Provider Name (Legal Business Name): PHARMACY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 INDUSTRIAL BLVD
HAWKINSVILLE GA
31036-2106
US

IV. Provider business mailing address

440 INDUSTRIAL BLVD P.O. BOX 1033
HAWKINSVILLE GA
31036-2106
US

V. Phone/Fax

Practice location:
  • Phone: 478-783-4988
  • Fax:
Mailing address:
  • Phone: 478-783-4988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number000271
License Number StateGA

VIII. Authorized Official

Name: DEBORAH COLEY
Title or Position: MEDICARE PART B COORDINATOR
Credential:
Phone: 478-783-4988