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
1	3336C0003X	Community/Retail Pharmacy
2	333600000X	Pharmacy	PP482598	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2155178	OTHER		PK

General Provider Information

NPI Number	:	1790157618
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIER PHARMACY LLC

Provider Business Mailing Address
First Line	:	150 MONUMENT RD
Second Line	:	SUITE 601A
City	:	BALA CYNWYD
State	:	PA
Zip	:	19004-1702
Country	:	US
Telephone Number	:	484-270-6501
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 MONUMENT RD STE 601A
Second Line	:
City	:	BALA CYNWYD
State	:	PA
Zip	:	19004-1701
Country	:	US
Telephone Number	:	484-270-6501
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MIROSLAV KESIC
Credential	:
Telephone Number	:	484-270-6501

Provider Enumeration Date	:	10/30/2015
Last Update Date	:	11/18/2015

Similar Medicare Providers

1366368391 — MACKENZIE GALLANT
Practice Location Address:

150 MONUMENT RD STE 600
BALA CYNWYD, PA
19004-1701

Practice Phone: 610-747-3400
Practice Fax:

1306882709 — WISSAHICKON HOSPICE OF UPHS
Practice Location Address:

150 MONUMENT RD STE 600
BALA CYNWYD, PA
19004-1701

Practice Phone: 610-617-2400
Practice Fax: 610-617-2438

1700813649 — WISSAHICKON HOSPICE OF UPHS
Practice Location Address:

150 MONUMENT RD STE 600
BALA CYNWYD, PA
19004-1701

Practice Phone: 610-617-2400
Practice Fax: 610-617-2438

1427324482 — CITY LINE PHARMACY LLC
Practice Location Address:

150 MONUMENT RD STE 601C
BALA CYNWYD, PA
19004-1701

Practice Phone: 610-664-7100
Practice Fax: 866-403-7224

1114361839 — ALEXANDRA MARIE RISTOW M.D.
Practice Location Address:

150 MONUMENT RD STE 500
BALA CYNWYD, PA
19004-1701

Practice Phone: 855-478-8208
Practice Fax:

1669849261 — CHRISTINA ELIZABETH WORST CRNP
Practice Location Address:

150 MONUMENT RD STE 600
BALA CYNWYD, PA
19004-1701

Practice Phone: 610-617-2415
Practice Fax: 215-893-5560

Directions to “PREMIER PHARMACY LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.