Provider Demographics
NPI:1336167337
Name:PHARMACY SERVICES INC
Entity type:Organization
Organization Name:PHARMACY SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:PECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-546-5200
Mailing Address - Street 1:2195 RT 442 HWY SUITE 1
Mailing Address - Street 2:
Mailing Address - City:MUNCY
Mailing Address - State:PA
Mailing Address - Zip Code:17756-9801
Mailing Address - Country:US
Mailing Address - Phone:570-546-5200
Mailing Address - Fax:570-546-7409
Practice Address - Street 1:2195 RT 442 HWY SUITE 1
Practice Address - Street 2:
Practice Address - City:MUNCY
Practice Address - State:PA
Practice Address - Zip Code:17756-9801
Practice Address - Country:US
Practice Address - Phone:570-546-5200
Practice Address - Fax:570-546-7409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X, 3336S0011X
PAPP414595L3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1281470Medicaid
3964841OtherNCPDP PROVIDER IDENTIFICATION NUMBER
0352030001Medicare NSC