Provider Demographics
NPI:1679938898
Name:GPS PHARMACY SOLUTIONS LLC
Entity Type:Organization
Organization Name:GPS PHARMACY SOLUTIONS LLC
Other - Org Name:GPS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULYA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-462-6445
Mailing Address - Street 1:163 S TRADE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-5929
Mailing Address - Country:US
Mailing Address - Phone:980-245-2028
Mailing Address - Fax:
Practice Address - Street 1:163 S TRADE ST
Practice Address - Street 2:SUITE A
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5929
Practice Address - Country:US
Practice Address - Phone:980-245-2028
Practice Address - Fax:980-245-2224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-16
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH022597950-03333600000X
NC127763336C0003X
SC165533336C0004X
3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2156041OtherPK