Healthcare Provider Details

I. General information

NPI: 1558138149
Provider Name (Legal Business Name): PREMIER COMMUNITY HEALTH CARE GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2023
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5957 ROWAN RD
NEW PORT RICHEY FL
34653-4531
US

IV. Provider business mailing address

PO BOX 232
DADE CITY FL
33526-0232
US

V. Phone/Fax

Practice location:
  • Phone: 352-518-2000
  • Fax:
Mailing address:
  • Phone: 352-518-2000
  • Fax: 352-567-0218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH RESNICK
Title or Position: CEO
Credential:
Phone: 352-518-2000