Healthcare Provider Details

I. General information

NPI: 1891717260
Provider Name (Legal Business Name): ONCOLOGY PHARMACY SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 01/12/2024
Certification Date: 01/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2410 ROUND ROCK AVE
ROUND ROCK TX
78681-4003
US

IV. Provider business mailing address

PO BOX 731145
DALLAS TX
75373-1145
US

V. Phone/Fax

Practice location:
  • Phone: 512-687-0368
  • Fax: 512-687-0300
Mailing address:
  • Phone: 972-997-8103
  • Fax: 469-467-2535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number24122
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: J ERNEST SIMS
Title or Position: DIRECTOR
Credential:
Phone: 972-490-2912