Healthcare Provider Details

I. General information

NPI: 1144146010
Provider Name (Legal Business Name): PSR WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1390 RAILROAD AVE
SAINT HELENA CA
94574-1124
US

IV. Provider business mailing address

1390 RAILROAD AVE
SAINT HELENA CA
94574-1124
US

V. Phone/Fax

Practice location:
  • Phone: 707-963-2794
  • Fax: 707-963-1954
Mailing address:
  • Phone: 707-963-2794
  • Fax: 707-963-1954

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. PRATAP KRISHNA ANNE
Title or Position: PHARMACY DIRECTOR
Credential:
Phone: 209-395-0555