Basic Information
| Provider Information | |||||||||
| NPI: | 1821314907 | ||||||||
| 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: | 1006 HIGHLAND AVE | ||||||||
| Address2: | |||||||||
| City: | SHREVEPORT | ||||||||
| State: | LA | ||||||||
| PostalCode: | 711014103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3186787579 | ||||||||
| FaxNumber: | 3186787580 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/14/2010 | ||||||||
| LastUpdateDate: | 08/01/2013 | ||||||||
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| AuthorizedOfficialLastName: | GREEN | ||||||||
| AuthorizedOfficialFirstName: | JANUARY | ||||||||
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| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT, BUSINESS OPERA | ||||||||
| AuthorizedOfficialTelephone: | 3343567627 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3336I0012X | PHY.6226-HOS | LA | Y | Suppliers | Pharmacy | Institutional Pharmacy |
ID Information
| ID | Type | State | Issuer | Description | 2124103 | 01 | PK | OTHER |