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NPI Code Detail

MEDICARE: ONCOLOGY PHARMACY SERVICES , INC.

MEDICARE: ONCOLOGY PHARMACY 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
1333600000XPharmacy16612TX
23336C0003XCommunity/Retail Pharmacy
33336S0011XSpecialty Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1350176OTHERTXTX VENDOR DRUG
235750OTHERTXTEXAS BOARD OF PHARMACY
316612OTHERTXCLASS A LIC
44595003OTHERTXNCPDP
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720024201
Entity Type Code : Organization
Provider Name (Legal Business Name) : ONCOLOGY PHARMACY SERVICES , INC.
Provider Business Mailing Address
First Line : PO BOX 731145
Second Line :
City : DALLAS
State : TX
Zip : 75373-1145
Country : US
Telephone Number : 972-997-8103
Fax Number : 469-467-2535
Provider Business Practice Location Address
First Line : 1901 GRANDVIEW AVE
Second Line :
City : EL PASO
State : TX
Zip : 79902-5113
Country : US
Telephone Number : 915-747-4840
Fax Number : 915-532-7116
Authorized Official
Title or Position : SR. REVENUE CYCLE MANAGER
Name : TODD KEVIN BIVONA
Credential :
Telephone Number : 214-794-5388
Provider Enumeration Date : 06/21/2006
Last Update Date : 06/10/2025

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Directions to “ONCOLOGY PHARMACY SERVICES , INC. ” Practice Location

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