Pci Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE010351 Issued in GA

Legal business name

PCI PHARMACY INC

Doing business as

Pci Pharmacy

Practice address

3500 N Decatur Rd Ste 108
Scottdale, GA 30079-6817

Phone

(404) 549-8447

Fax

(678) 973-0535

NPI assigned

Apr 5, 2017

Organization subpart

No

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

Authorized official

Name

Mba Ukoha Kalu, PHARMACISTNPI 1578710497

Title

Ceo

Phone

(404) 549-8447

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• PCI PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Pci Pharmacy Inc

  • Long Term Care Pharmacy
  • Scottdale, GA
  • NPI 1124916556
  NPPES parent name

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.

• Mba Ukoha Kalu, RPH

  • Pharmacist
  • Lithonia, GA
  • NPI 1578710497
  NPD Authorized official

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

{
    "created_epoch": "1491350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520899200000",
    "number": "1962935098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 N DECATUR RD",
            "address_2": "SUITE 108",
            "city": "SCOTTDALE",
            "state": "GA",
            "postal_code": "300796816",
            "telephone_number": "404-549-8447",
            "fax_number": "678-973-0535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 N DECATUR RD STE 108",
            "city": "SCOTTDALE",
            "state": "GA",
            "postal_code": "300796817",
            "telephone_number": "404-549-8447",
            "fax_number": "678-973-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PCI PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-05",
        "last_updated": "2018-03-13",
        "status": "A",
        "authorized_official_last_name": "KALU",
        "authorized_official_first_name": "MBA",
        "authorized_official_middle_name": "UKOHA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-549-8447",
        "authorized_official_credential": "PHARMACIST"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE010351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003190274A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2168763",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PCI PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Scottdale, GA
• Providers in Scottdale, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2018; 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.