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General NPI Number Information
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NPI Number | 1558764159
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Entity Type | Organization
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Legal Business Name | PREMIER PHARMACY CARE LLC
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Dates
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Enumeration Date | 09/27/2014
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 760 MICHAELA DR.
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72117
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Country | US
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Telephone | 501-992-1006
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Fax | 501-992-1013
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Provider Business Mailing Address
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Address Line | 760 MICHAELA DR.
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72117
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Country | US
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Telephone | 501-992-1006
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Fax | 501-992-1013
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Authorized Official
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Title or Position | COO
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Name | DR. TRAVIS EZELL
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Credential | PHARMD
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Telephone | 501-992-1006
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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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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | AR20771
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License Number State | AR
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