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NPI Code Detail

MEDICARE: PREMIER PHARMACY LLC

MEDICARE: PREMIER PHARMACY LLC
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
13336C0003XCommunity/Retail Pharmacy

General Provider Information

NPI Number : 1518709153
Entity Type Code : Organization
Provider Name (Legal Business Name) : PREMIER PHARMACY LLC
Provider Business Mailing Address
First Line : 476 GRANT ST
Second Line :
City : BUFFALO
State : NY
Zip : 14213-1145
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 476 GRANT ST
Second Line :
City : BUFFALO
State : NY
Zip : 14213-1145
Country : US
Telephone Number : 716-465-5459
Fax Number :
Authorized Official
Title or Position : OWNER/SUPERVISING PHARMACIST
Name : YASIN OMAR
Credential : PHARMD
Telephone Number : 716-465-5459
Provider Enumeration Date : 06/12/2024
Last Update Date : 06/12/2024

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Directions to “PREMIER PHARMACY LLC ” Practice Location

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