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Organization
PSI, LLC
Active
Organization
PSI, LLC
Active
Other names
ElderCare Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES RUSTY LEE JR. RPH (PRESIDENT)
(478) 783-1515
Entity
Organization
Contact information
Practice address
4315 BELAIR FRONTAGE RD, AUGUSTA, GA 30909-9412
(888) 858-6051
(888) 858-6052
Mailing address
4315 BELAIR FRONTAGE RD, AUGUSTA, GA 30909-9412
(888) 858-6051
(888) 858-6052
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00835942A
—
GA
01
—
1146415
NCPDP
GA
Enumeration date
08/19/2005
Last updated
09/27/2016
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