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General NPI Number Information
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NPI Number | 1245523521
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Entity Type | Organization
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Legal Business Name | PREMIER ONE PHARMACY INC.
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Dates
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Enumeration Date | 05/19/2011
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 4112A MAIN ST FL 1
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City | FLUSHING
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State | NY
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Zip | 11355-3348
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Country | US
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Telephone | 718-886-7128
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Fax | 718-886-7138
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Provider Business Mailing Address
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Address Line | 4112A MAIN ST FL 1
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City | FLUSHING
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State | NY
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Zip | 11355-3348
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Country | US
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Telephone | 718-886-7128
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Fax | 718-886-7138
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Authorized Official
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Title or Position | OWNER
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Name | JUSTIN CHAN
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Credential |
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Telephone | 718-886-7128
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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