Provider Demographics
NPI:1427309343
Name:PS OF MI, LLC
Entity type:Organization
Organization Name:PS OF MI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCIAL OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CHANA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-389-1818
Mailing Address - Street 1:150 PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-4185
Mailing Address - Country:US
Mailing Address - Phone:908-389-1818
Mailing Address - Fax:732-985-5899
Practice Address - Street 1:13042 FAIRLANE ST
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-1326
Practice Address - Country:US
Practice Address - Phone:908-389-1818
Practice Address - Fax:508-281-1843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-02
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0002X, 3336C0004X, 3336I0012X
MI53010099203336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2137221OtherPK
2377186OtherNCPDP PROVIDER IDENTIFICATION NUMBER