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General NPI Number Information
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NPI Number | 1073198131
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Entity Type | Organization
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Legal Business Name | PREMIER PHARMACY SERVICES INC
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Dates
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Enumeration Date | 03/10/2021
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Last Update Date | 10/08/2021
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Provider Practice Location Address
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Address Line | 2105 GLEN DR
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City | MILLERSBURG
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State | OH
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Zip | 44654-8905
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Country | US
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Telephone | 234-301-9166
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Fax | 234-301-9187
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Provider Business Mailing Address
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Address Line | PO BOX 78
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City | BERLIN
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State | OH
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Zip | 44610-0078
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Country | US
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Telephone | 330-893-0290
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOEL GAUSE
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Credential |
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Telephone | 330-893-0290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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