Healthcare Provider Details

I. General information

NPI: 1386681369
Provider Name (Legal Business Name): PHARM SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 07/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 HIGHWAY 82 E
INDIANOLA MS
38751-2339
US

IV. Provider business mailing address

1510 HIGHWAY 82 E
INDIANOLA MS
38751-2339
US

V. Phone/Fax

Practice location:
  • Phone: 662-887-5004
  • Fax: 662-887-1002
Mailing address:
  • Phone: 662-887-5004
  • Fax: 662-887-1002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberD05311
License Number StateMS

VIII. Authorized Official

Name: GERALD WAYNE PUGH
Title or Position: PRESIDENT
Credential:
Phone: 662-887-5004