Provider Demographics
NPI:1861438749
Name:ONCOLOGY PHARMACY SERVICES, INC
Entity type:Organization
Organization Name:ONCOLOGY PHARMACY SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:J.
Authorized Official - Middle Name:ERNEST
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-490-2912
Mailing Address - Street 1:PO BOX 731145
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-1145
Mailing Address - Country:US
Mailing Address - Phone:972-997-8103
Mailing Address - Fax:469-467-2535
Practice Address - Street 1:4101 JAMES CASEY ST
Practice Address - Street 2:SUITE 250
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-3325
Practice Address - Country:US
Practice Address - Phone:512-416-5132
Practice Address - Fax:512-462-9751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2020-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20029332B00000X, 333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080746301OtherTPI
TX4500181OtherNCPDP
TX350151OtherHHSC VENDOR
TX20029OtherCLASS A LIC
TX20029OtherCLASS A LIC