Organization
INNOVATIVE PHARMACY SERVICES INC
Active
Other names
Guy's Innovative Pharmacy Vital Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOE KEITH GUY RPH (PRESIDENT)
(601) 684-4127
Entity
Organization
Contact information
Practice address
312B MARION AVE, MCCOMB, MS 39648-2708
(601) 684-4127
(601) 684-8479
Mailing address
312B MARION AVE, MCCOMB, MS 39648-2708
(601) 684-4127
(601) 684-8479
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
03331/02.0
MS
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
0331/02.0
MS
333600000X
Pharmacy
03331/02.0
MS
3336H0001X
Home Infusion Therapy Pharmacy
03331/02.0
MS
3336S0011X
Specialty Pharmacy
03331/02.0
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000030276
BCBS OF MS
MS
05
—
00579729
—
MS
05
—
04784248
—
MS
05
—
07879769
—
MS
Enumeration date
06/13/2006
Last updated
08/17/2018
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