Physician Support Associates PC

Primary specialty

Home Infusion Therapy PharmacyTaxonomy code 3336H0001X

License

PHRE006546 Issued in GA

Legal business name

PHYSICIAN SUPPORT ASSOCIATES PC

Doing business as

Physician Support Associates Inc

Practice address

1021 Daisy Park
Macon, GA 31201-2020

Phone

(478) 746-2842

Fax

(478) 746-8362

NPI assigned

Nov 15, 2006

Last updated

Mar 14, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Iteogu, PHARMDNPI 1932789104

Title

President

Phone

(478) 746-2842

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• PHYSICIAN SUPPORT ASSOCIATES INC Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Ogbenna Iteogu, RPH

  • Pharmacist
  • Macon, GA
  • NPI 1932789104
  NPD (past) Authorized official

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363219200000",
    "number": "1013089994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 DAISY PARK",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012020",
            "telephone_number": "478-746-2842",
            "fax_number": "478-746-8362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 DAISY PARK",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012020",
            "telephone_number": "478-746-2842",
            "fax_number": "478-746-8362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN SUPPORT ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2013-03-14",
        "status": "A",
        "authorized_official_last_name": "ITEOGU",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "478-746-2842",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "GA",
            "license": "PHRE006546",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000320251A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1140336",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHYSICIAN SUPPORT ASSOCIATES INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dan Emory Phillips, MD
• James E Phillips, MD
• Jasmine Phillips
• Physician Consultants of Georgia
• Physician Consultants of Georgia Interventional LLC (Midtown Vascular Center)
• Physicians & Midwives of Macon, P.C.
• Physicians Alliance LLC
• Physicians Care Center LLC
• Physicians MRI Inc (Open MRI of Macon)
• Physio at Hammonds Centre LLC (Physio)

• Home Infusion Therapy Pharmacy in Macon, GA
• Providers in Macon, GA by specialty
• Home Infusion Therapy Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.