Healthcare Provider Details

I. General information

NPI: 1932630126
Provider Name (Legal Business Name): PHARMACEUTICAL SPECIALTIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2017
Last Update Date: 12/15/2023
Certification Date: 12/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 CLEVELAND RD STE B
BOGART GA
30622-1701
US

IV. Provider business mailing address

PO BOX 1353
AMARILLO TX
79105-1353
US

V. Phone/Fax

Practice location:
  • Phone: 800-818-6486
  • Fax: 706-621-7263
Mailing address:
  • Phone: 806-242-7782
  • Fax: 706-621-7263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License NumberPHHH000053
License Number StateGA

VIII. Authorized Official

Name: JOEL WRIGHT
Title or Position: PRESIDENT PHARMACY SERVICES
Credential:
Phone: 806-242-7782