Healthcare Provider Details

I. General information

NPI: 1548767395
Provider Name (Legal Business Name): PREMIER PHARMACY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2018
Last Update Date: 07/22/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 OAK ST.
BERLIN OH
44610
US

IV. Provider business mailing address

PO BOX 78
BERLIN OH
44610-0078
US

V. Phone/Fax

Practice location:
  • Phone: 330-893-0290
  • Fax: 330-449-9976
Mailing address:
  • Phone: 330-204-6734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number022886200
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOEL GAUSE
Title or Position: PRESIDENT
Credential:
Phone: 330-204-6734