Platinum Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PLATINUM PHARMACY LLC

Practice address

935 Lanier Ave W Ste 1008
Fayetteville, GA 30214-7434

Phone

(404) 902-5811

Fax

(678) 519-3115

NPI assigned

Oct 1, 2018

Organization subpart

No

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

Authorized official

Name

Samuel ObichiNPI 1780095406

Title

Owner

Phone

(404) 822-4505

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PLATINUM PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samuel Obichi

  • Pharmacist
  • Austell, GA
  • NPI 1780095406
  NPD Authorized official

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

{
    "created_epoch": "1538352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752105600000",
    "number": "1003391491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 LANIER AVE W STE 1008",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147434",
            "telephone_number": "404-902-5811",
            "fax_number": "678-519-3115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 LANIER AVE W STE 1008",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147434",
            "telephone_number": "404-902-5811",
            "fax_number": "678-519-3115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLATINUM PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-01",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A",
        "authorized_official_last_name": "OBICHI",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-822-4505"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003212737A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PLATINUM PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Piedmont Fayette Hospital
• Lauren Piilola
• Thomas Hugh Pinaud
• Emile C Pinera, M.D.
• Platinum Healthcare Services
• Plattaz Dialysis, LLC
• Elisabeth Pleasant
• Lauren Lee Polito, D.M.D
• Yolanda Polk
• Arvind Jayaraj Ponnambalam, MD

• Community/Retail Pharmacy in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.