MEDICARE: PHARMACEUTICAL SPECIALTIES 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	07602	NC

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	:	1932213634
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHARMACEUTICAL SPECIALTIES INC

Provider Business Mailing Address
First Line	:	756 TYVOLA RD STE 112A
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28217-3535
Country	:	US
Telephone Number	:	704-519-0617
Fax Number	:

Provider Business Practice Location Address
First Line	:	756 TYVOLA RD STE 112A
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28217-3535
Country	:	US
Telephone Number	:	704-519-0617
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PHARMACIST
Name	:	MR. KEITH SLEDGE
Credential	:	R.PH
Telephone Number	:	704-519-0617

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	08/22/2020

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Directions to “PHARMACEUTICAL SPECIALTIES INC ” Practice Location

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