MEDICARE: WS AND SKY 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	3336C0003X	Community/Retail Pharmacy	PHRE009522	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2117750	OTHER		PK

General Provider Information

NPI Number	:	1003060609
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WS AND SKY INC

Provider Business Mailing Address
First Line	:	2790 LAWRENCEVILLE SUWANEE RD
Second Line	:	STE 150
City	:	SUWANEE
State	:	GA
Zip	:	30024-2671
Country	:	US
Telephone Number	:	770-932-3023
Fax Number	:	770-932-2314

Provider Business Practice Location Address
First Line	:	2790 LAWRENCEVILLE SUWANEE RD
Second Line	:	STE 150
City	:	SUWANEE
State	:	GA
Zip	:	30024-2671
Country	:	US
Telephone Number	:	770-932-3023
Fax Number	:	770-932-2314

Authorized Official
Title or Position	:	MGMNT, PIC
Name	:	SARA YIM
Credential	:	RPH
Telephone Number	:	770-932-3023

Provider Enumeration Date	:	11/10/2008
Last Update Date	:	03/30/2015

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Directions to “WS AND SKY INC ” Practice Location

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