Active NPI
Samuel Obichi
- Pharmacist
- Austell, GA
National Provider Identifier
1780095406
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 021536
- Practice address
- 2105 Mesa Valley Way
Austell, GA 30106-8183 - Phone
- (404) 822-4505
- NPI assigned
- May 15, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 021536 | GA | Primary |
Addresses
Primary practice location
2105 Mesa Valley Way
Austell, GA 30106-8183
Mailing address
2105 Mesa Valley Way
Austell, GA 30106-8183
Phone (404) 822-4505
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021536 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Platinum Pharmacy LLC | Current | Accepting new patients | |
| Platinum Healthcare Services | Current | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Skilled Nursing Facility
- Fayetteville, GA
- NPI 1063263929
-
dba Platinum Pharmacy
- Community/Retail Pharmacy
- Fayetteville, GA
- NPI 1003391491
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400112000000",
"number": "1780095406",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2105 MESA VALLEY WAY",
"city": "AUSTELL",
"state": "GA",
"postal_code": "301068183",
"telephone_number": "404-822-4505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2105 MESA VALLEY WAY",
"city": "AUSTELL",
"state": "GA",
"postal_code": "301068183",
"telephone_number": "404-822-4505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBICHI",
"first_name": "SAMUEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-05-15",
"last_updated": "2014-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "021536",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austell, GA
- Darious N Nwadike, DDS
- Chinyelu Obiamaka Nwobu, M.D., M.P.H.
- Lisa Anne Oakley, MD
- Warren Todd Oberle, MD
- Romanus C Obialor
- Observation Medicine Specialists LLC
- Occupational Health Centers of Georgia PC (Concentra Medical Center)
- Bryan Sho Odakura, PT
- Nnaemezie Emmanuel Odioemene, M.D
- James F Odom, PAC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.