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General NPI Number Information
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NPI Number | 1104868405
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL PHARMACY SERVICES, INC.
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 02/15/2016
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Provider Practice Location Address
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Address Line | 1112 6TH AVE STE 101
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City | TACOMA
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State | WA
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Zip | 98405-4040
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Country | US
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Telephone | 253-272-1107
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Fax | 253-272-7327
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Provider Business Mailing Address
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Address Line | 201 E 4TH ST 900 OMNICARE CENTER
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City | CINCINNATI
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State | OH
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Zip | 45202-4248
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | REGULATORY LICENSING MANGAGER
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Name | ANGELA JAMES
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Credential |
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Telephone | 513-719-2600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | CF00059109
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License Number State | WA
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