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General NPI Number Information
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NPI Number | 1326314733
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Entity Type | Organization
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Legal Business Name | PREMIER KIDS CARE, INC.
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Dates
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Enumeration Date | 03/29/2012
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Last Update Date | 03/29/2012
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Provider Practice Location Address
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Address Line | 221 PLAZA DR
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City | MONROE
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State | GA
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Zip | 30655-3184
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Country | US
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Telephone | 888-892-9001
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Fax | 866-810-4012
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Provider Business Mailing Address
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Address Line | 221 PLAZA DR
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City | MONROE
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State | GA
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Zip | 30655-3184
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Country | US
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Telephone | 888-892-9001
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Fax | 866-810-4012
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | JOY A. CHESNUT
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Credential | RN
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Telephone | 888-892-9001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHRE008225
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License Number State | GA
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