Healthcare Provider Details

I. General information

NPI: 1942211594
Provider Name (Legal Business Name): PHARMACY SOLUTIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 03/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1516 WASHINGTON ST
TWO RIVERS WI
54241-3045
US

IV. Provider business mailing address

1516 WASHINGTON ST
TWO RIVERS WI
54241-3045
US

V. Phone/Fax

Practice location:
  • Phone: 920-553-1225
  • Fax:
Mailing address:
  • Phone: 920-553-1225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number8571042
License Number StateWI

VIII. Authorized Official

Name: MARVIN MOORE
Title or Position: PRESIDENT
Credential: PHARMD
Phone: 920-794-1225