Basic Information
| Provider Information | |||||||||
| NPI: | 1629376199 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | INSTITUTIONAL PHARMACY SOLUTIONS LLC | ||||||||
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| OtherOrganizationName: | INSTITUTIONAL PHARMACY SOLUTIONS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3480 EASTERN BLVD | ||||||||
| Address2: | |||||||||
| City: | MONTGOMERY | ||||||||
| State: | AL | ||||||||
| PostalCode: | 361161700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3348194500 | ||||||||
| FaxNumber: | 3348194520 | ||||||||
| Practice Location | |||||||||
| Address1: | 5900 W ROCHELLE AVE | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891033304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7023641111 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2011 | ||||||||
| LastUpdateDate: | 08/03/2016 | ||||||||
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| AuthorizedOfficialLastName: | GREEN | ||||||||
| AuthorizedOfficialFirstName: | JANUARY | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP OF HUMAN RESOURCES | ||||||||
| AuthorizedOfficialTelephone: | 3348194500 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 333600000X | PH02706 | NV | Y | Suppliers | Pharmacy |
ID Information
| ID | Type | State | Issuer | Description | 2131539 | 01 | PK | OTHER |