Pruitthealth Pharmacy Services - Atlanta, Inc.

Primary specialty

Home Infusion Therapy PharmacyTaxonomy code 3336H0001X

Legal business name

PRUITTHEALTH PHARMACY SERVICES - ATLANTA, INC.

Practice address

1626 Jeurgens CT
Norcross, GA 30093-2219

Phone

(678) 533-6459

Fax

(770) 931-5253

NPI assigned

Feb 20, 2007

Organization subpart

No

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

Authorized official

Name

Neil L Pruitt Jr.

Title

Chairman & Ceo

Phone

(770) 279-6200

Specialties & licenses 7

Addresses

Other identifiers 2

Other names 1

• PruittHealth Pharmacy Services - Atlanta Doing business as

Medicare fee-for-service enrollment

Enrolled in GA4 enrollments

Home infusion therapy

Medicare-enrolled home infusion therapy supplier

Enrollment records 4

Locations

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633564800000",
    "number": "1962547992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 JEURGENS CT",
            "address_2": "LEGAL DEPT",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300932219",
            "telephone_number": "678-533-6459",
            "fax_number": "770-931-5253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1626 JEURGENS CT",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300932219",
            "telephone_number": "678-533-6459",
            "fax_number": "770-931-5253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUITTHEALTH PHARMACY SERVICES - ATLANTA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2021-10-07",
        "certification_date": "2021-09-23",
        "status": "A",
        "authorized_official_last_name": "PRUITT",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHAIRMAN & CEO",
        "authorized_official_telephone_number": "770-279-6200",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "GA",
            "license": "PHRE009153",
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "GA",
            "license": "PHRE009153",
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "295907416A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2119656",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PruittHealth Pharmacy Services - Atlanta",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PruittHealth Pharmacy Services - Atlanta",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pruitthealth Home Health, Inc.
• Pruitthealth Hospice, Inc.
• Pruitthealth Nutritional Supply, Inc.
• Pruitthealth Pharmacy Services - Atlanta, Inc.
• Pruitthealth Pharmacy Services - Atlanta, Inc.
• Pruitthealth Pharmacy Services - Norcross, Inc.
• Pruitthealth Physicians Services, LLC
• Pruitthealth Therapy Services
• Pruitthealth Therapy Services, Inc.
• Psych Connection LLC

• Home Infusion Therapy Pharmacy in Norcross, GA
• Providers in Norcross, 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 Oct 7, 2021; 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.