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General NPI Number Information
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NPI Number | 1003852088
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL PHARMACY SERVICES
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 06/02/2011
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Provider Practice Location Address
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Address Line | 2001 S SHIELDS ST BLDG D
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City | FORT COLLINS
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State | CO
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Zip | 80526-1827
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Country | US
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Telephone | 970-224-1212
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Fax | 970-224-3113
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Provider Business Mailing Address
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Address Line | 3780 E 15TH ST SUITE 102
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City | LOVELAND
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State | CO
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Zip | 80538-8766
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Country | US
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Telephone | 970-461-1975
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Fax | 970-461-4042
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Authorized Official
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Title or Position | PRESIDENT
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Name | VICKI EINHELLIG
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Credential | RPH
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Telephone | 970-461-1975
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 44-44
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License Number State | CO
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