Professional Pharmacy Services Inc.

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

AR-20331 Issued in AR

Legal business name

PROFESSIONAL PHARMACY SERVICES INC.

Practice address

1907 N Medical Park Dr
Suite 103
Greenville, MS 38703-7240

Phone

(662) 378-3850

Fax

(662) 332-0195

NPI assigned

Sep 12, 2006

Organization subpart

No

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

Authorized official

Name

Khalil L Crouse

Title

Manager

Phone

(870) 265-2220

Specialties & licenses 10

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455235200000",
    "number": "1992809560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 552",
            "city": "LAKE VILLAGE",
            "state": "AR",
            "postal_code": "716530552",
            "telephone_number": "662-378-8860",
            "fax_number": "662-378-8618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 N MEDICAL PARK DR",
            "address_2": "SUITE 103",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387037240",
            "telephone_number": "662-378-3850",
            "fax_number": "662-332-0195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PHARMACY SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2016-02-12",
        "status": "A",
        "authorized_official_last_name": "CROUSE",
        "authorized_official_first_name": "KHALIL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "870-265-2220"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AR",
            "license": "AR-20331",
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "AR",
            "license": "AR-20331",
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "AR",
            "license": "AR-20331",
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "AR",
            "license": "AR-20331",
            "primary": true
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "AR",
            "license": "AR-20331",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "AR-20331",
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "AR",
            "license": "AR-20331",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "AR",
            "license": "AR-20331",
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "AR",
            "license": "AR-20331",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "AR",
            "license": "AR-20331",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115721716",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4A032",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116277407",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.