NPIMap

Organization Active NPI

Professional Pharmacy Services, Inc.

  • Community/Retail Pharmacy
  • Tacoma, WA
National Provider Identifier
1104868405
Registry record updated Feb 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
CF00059109 Issued in WA
Legal business name
PROFESSIONAL PHARMACY SERVICES, INC.
Practice address
1112 6TH Ave
Ste 101
Tacoma, WA 98405-4040
Phone
(253) 272-1107
Fax
(253) 272-7327
NPI assigned
Jun 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Angela James
Title
Regulatory Licensing Mangager
Phone
(513) 719-2600

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X CF00059109 WA Primary

Addresses

Primary practice location

1112 6TH Ave
Ste 101
Tacoma, WA 98405-4040

Mailing address

201 E 4TH St
900 Omnicare Center
Cincinnati, OH 45202-4248

Other identifiers 2

IdentifierTypeStateIssuer
4913768OtherOTHER ID NUMBER-COMMERCIAL NUMBER
6030738MedicaidWA

Other names 1

  • PUGET SOUND PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Professional Pharmacy Ser5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455494400000",
    "number": "1104868405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E 4TH ST",
            "address_2": "900 OMNICARE CENTER",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452024248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 6TH AVE",
            "address_2": "STE 101",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054040",
            "telephone_number": "253-272-1107",
            "fax_number": "253-272-7327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PHARMACY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2016-02-15",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "REGULATORY LICENSING MANGAGER",
        "authorized_official_telephone_number": "513-719-2600"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "CF00059109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "4913768",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6030738",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PUGET SOUND PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.