Provider Demographics
NPI:1679763957
Name:PHARMACY SERVICES, INC
Entity type:Organization
Organization Name:PHARMACY SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:LUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:515-967-4214
Mailing Address - Street 1:120 8TH ST SE
Mailing Address - Street 2:SUITE B
Mailing Address - City:ALTOONA
Mailing Address - State:IA
Mailing Address - Zip Code:50009-1950
Mailing Address - Country:US
Mailing Address - Phone:515-967-4214
Mailing Address - Fax:515-967-3402
Practice Address - Street 1:120 8TH ST SE
Practice Address - Street 2:SUITE B
Practice Address - City:ALTOONA
Practice Address - State:IA
Practice Address - Zip Code:50009-1950
Practice Address - Country:US
Practice Address - Phone:515-967-4214
Practice Address - Fax:515-967-3402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA13273336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1327OtherPHARMACY LICENSE
IA1623114OtherNCPDP