Provider Services of America, LLC

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

Legal business name

PROVIDER SERVICES OF AMERICA, LLC

Practice address

2385 NW Executive Center Dr
Suite 100
Boca Raton, FL 33431-8579

Phone

(561) 463-8102

Fax

(561) 331-2707

NPI assigned

May 25, 2016

Organization subpart

Yes

Parent organization

OFFICE COMPOUNDING SOLUTIONS, LLCAs reported in NPPES

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

Authorized official

Name

Harrison Zipper

Title

Owner

Phone

(561) 463-8102

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1464134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464220800000",
    "number": "1689022147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 812140",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334812140",
            "telephone_number": "561-463-8102",
            "fax_number": "561-331-2707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2385 NW EXECUTIVE CENTER DR",
            "address_2": "SUITE 100",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334318579",
            "telephone_number": "561-463-8102",
            "fax_number": "561-331-2707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDER SERVICES OF AMERICA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OFFICE COMPOUNDING SOLUTIONS, LLC",
        "enumeration_date": "2016-05-25",
        "last_updated": "2016-05-26",
        "status": "A",
        "authorized_official_last_name": "ZIPPER",
        "authorized_official_first_name": "HARRISON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-463-8102"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CITY TAX RECEIPT",
            "identifier": "16-00063751",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Non-Pharmacy Dispensing Site in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Non-Pharmacy Dispensing Site in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2016; 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.