Healthcare Provider Details

I. General information

NPI: 1184194276
Provider Name (Legal Business Name): PHARMA SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2018
Last Update Date: 12/30/2021
Certification Date: 12/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1183 ACUSHNET AVE
NEW BEDFORD MA
02746-1905
US

IV. Provider business mailing address

PO BOX 2007
NEW BEDFORD MA
02741-2007
US

V. Phone/Fax

Practice location:
  • Phone: 508-817-5044
  • Fax: 774-305-4011
Mailing address:
  • Phone: 401-486-4789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336M0003X
TaxonomyManaged Care Organization Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: FELIX BAEZ
Title or Position: PHARMACIST
Credential: RPH
Phone: 401-486-4789