Healthcare Provider Details

I. General information

NPI: 1346233251
Provider Name (Legal Business Name): PREMIER HOME PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2005
Last Update Date: 03/30/2022
Certification Date: 03/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27762 FRANKLIN RD
SOUTHFIELD MI
48034-2300
US

IV. Provider business mailing address

27762 FRANKLIN RD
SOUTHFIELD MI
48034-2300
US

V. Phone/Fax

Practice location:
  • Phone: 248-223-9734
  • Fax: 248-223-9737
Mailing address:
  • Phone: 248-223-9734
  • Fax: 248-223-9737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. CRAIG LYNN CAMP
Title or Position: PRESIDENT
Credential: RPH
Phone: 248-223-9734