MEDICARE: PSRP INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0004X	Compounding Pharmacy
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy	PH25691	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2132055	OTHER		PK

General Provider Information

NPI Number	:	1073895777
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PSRP INC

Provider Business Mailing Address
First Line	:	2977 W COMMERCIAL BLVD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-3502
Country	:	US
Telephone Number	:	954-580-3006
Fax Number	:	954-828-0096

Provider Business Practice Location Address
First Line	:	2977 W COMMERCIAL BLVD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-3502
Country	:	US
Telephone Number	:	954-580-3006
Fax Number	:	954-828-0096

Authorized Official
Title or Position	:	PHARMACY MANAGER
Name	:	RONAK PATEL
Credential	:
Telephone Number	:	848-219-4847

Provider Enumeration Date	:	09/19/2011
Last Update Date	:	12/11/2014

Similar Medicare Providers

1558685776 — WESTSIDE PHARMACY LLC
Practice Location Address:

2977 W COMMERCIAL BLVD
FT LAUDERDALE, FL
33309-3502

Practice Phone: 954-484-8474
Practice Fax: 954-484-8475

1164857306 — LHC SKILLED CORP.
Practice Location Address:

2975B W COMMERCIAL BLVD
FT LAUDERDALE, FL
33309-3502

Practice Phone: 954-406-9616
Practice Fax: 561-450-1458

1770604720 — TRINITY HOME HEALTH CARE, INC.
Practice Location Address:

3502 STELLHORN RD
FORT WAYNE, IN
46815-4631

Practice Phone: 260-492-5804
Practice Fax:

1477749851 — EAC ANESTHESIA, PC
Practice Location Address:

3502 S N ST , APARTMENT D
FORT SMITH, AR
72903-2911

Practice Phone: 479-420-8552
Practice Fax:

1992030241 — DR. TROY KIRK LUNDELL DMD
Practice Location Address:

2901 CASSIDY RD
FORT BLISS, TX
79916-3502

Practice Phone: 915-742-2871
Practice Fax:

1477868651 — MRS. LISA ANN GIBSON MOTR
Practice Location Address:

1200 BARR ST
FORT WAYNE, IN
46802-3502

Practice Phone: 260-467-1110
Practice Fax:

Directions to “PSRP INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.