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General NPI Number Information
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NPI Number | 1285975573
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Entity Type | Organization
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Legal Business Name | PREMIER HEALTH PHARMACY INC
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Dates
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Enumeration Date | 03/12/2013
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Last Update Date | 03/15/2017
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Provider Practice Location Address
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Address Line | 20-07 127TH STREET #G33
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City | COLLEGE POINT
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State | NY
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Zip | 11356
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Country | US
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Telephone | 718-661-0872
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Fax |
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Provider Business Mailing Address
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Address Line | 20-07 127TH STREET #G33
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City | COLLEGE POINT
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State | NY
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Zip | 11356
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Country | US
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Telephone | 718-661-0872
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | FRANZ SUESS
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Credential |
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Telephone | 570-877-2536
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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 | 032019
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License Number State | NY
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