# PROFESSIONAL PHARMACY SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PROFESSIONAL PHARMACY SERVICES LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770525552
- **Authorized official:** MARC COHEN PHARM D (PRES)
- **Authorized official phone:** (801) 743-2800

## Contact information

- **Practice address:** 3793 S STATE ST, SALT LAKE CITY, UT 84115-4828
- **Practice address phone:** (801) 263-5466
- **Mailing address:** 3793 S STATE ST, SALT LAKE CITY, UT 84115-4828
- **Mailing address phone:** (801) 263-5466

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | 66379161704 | UT | Yes |

## Other

- **Enumeration date:** 06/13/2006
- **Last updated:** 08/28/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4610398 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |