Psi, LLC

Key facts

NPI

1801209804

Entity type

Organization (NPI type 2)

Primary specialty

Long Term Care Pharmacy 3336L0003X

Legal business name

PSI, LLC

Practice address

635 Cook St
Royston, GA 30662-3932

Phone

(762) 847-7403

Fax

(706) 245-1421

NPI assigned

Jun 6, 2014

Organization subpart

No

Authorized official

Name

Ms. Amanda T Roberson, RPH

Title

Vice President of Operations

Phone

(478) 783-1515

Corporate family (same tax ID) 3

Organizations that report the same tax identification number in the National Provider Directory.

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  NPD tax ID
• Pharmacy Services, Inc. Durable Medical Equipment & Medical Supplies · Hawkinsville, GA · NPI 1093704132
  NPD tax ID
• Pharmacy Services, Inc. Pharmacy · Hawkinsville, GA · NPI 1871585232
  NPD tax ID

National Provider Directory

Tax ID family

Psi LLC (4 organizations share this tax ID)

Locations

Specialties & licenses

Addresses

Other identifiers

Other names

• ElderCare Pharmacy Royston Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 27, 2016.

{
    "created_epoch": "1402012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474934400000",
    "number": "1801209804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 COOK ST",
            "city": "ROYSTON",
            "state": "GA",
            "postal_code": "306623932",
            "telephone_number": "762-847-7403",
            "fax_number": "706-245-1421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 COOK ST",
            "city": "ROYSTON",
            "state": "GA",
            "postal_code": "306623932",
            "telephone_number": "762-847-7403",
            "fax_number": "706-245-1421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-06",
        "last_updated": "2016-09-27",
        "status": "A",
        "authorized_official_last_name": "ROBERSON",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VICE PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "478-783-1515",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003148860A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ElderCare Pharmacy Royston",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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All providers in Royston, GA · Long Term Care Pharmacy in Georgia