MEDICARE: PHARM SERVICES INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	D05311	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386681369
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHARM SERVICES INC.

Provider Business Mailing Address
First Line	:	1510 HIGHWAY 82 E
Second Line	:
City	:	INDIANOLA
State	:	MS
Zip	:	38751-2339
Country	:	US
Telephone Number	:	662-887-5004
Fax Number	:	662-887-1002

Provider Business Practice Location Address
First Line	:	1510 HIGHWAY 82 E
Second Line	:
City	:	INDIANOLA
State	:	MS
Zip	:	38751-2339
Country	:	US
Telephone Number	:	662-887-5004
Fax Number	:	662-887-1002

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GERALD WAYNE PUGH
Credential	:
Telephone Number	:	662-887-5004

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	07/22/2008

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Directions to “PHARM SERVICES INC. ” Practice Location

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