| NPI | 1013089994 |
|---|---|
| Doing Business As | PHYSICIAN SUPPORT ASSOCIATES INC |
| Entity Type | Organization |
| Authorized Contact | MICHAEL ITEOGU President 478-746-2842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: GA PHRE006546) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2013-03-14 |