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
1	333600000X	Pharmacy	19977	TX
2	3336C0003X	Community/Retail Pharmacy
3	3336S0011X	Specialty Pharmacy

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
2	19977	OTHER	TX	CLASS A LICENSE
3	320216	OTHER	TX	TX VENDOR DRUG
4	4509189	OTHER	TX	NCPDP

General Provider Information

NPI Number	:	1811910201
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	:	5400 KELL WEST BLVD
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76310-1610
Country	:	US
Telephone Number	:	940-689-2632
Fax Number	:	940-692-1546

Authorized Official
Title or Position	:	DIRECTOR
Name	:	J ERNEST SIMS
Credential	:
Telephone Number	:	972-490-2912

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	01/12/2024

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Directions to “ONCOLOGY PHARMACY SERVICES INC ” Practice Location

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