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NPI 1598504417

NPI 1598504417 : PREMIUM HEALTH INC : FAR ROCKAWAY, NY

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General NPI Number Information
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    NPI Number           |    1598504417
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    Entity Type          |    Organization 
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    Legal Business Name  |    PREMIUM HEALTH INC 
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Dates
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    Enumeration Date     |    05/21/2024
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    Last Update Date     |    12/02/2025
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Provider Practice Location Address
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    Address Line         |    1212 SEAGIRT BOULEVARD SUITE 301
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    City                 |    FAR ROCKAWAY
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    State                |    NY
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    Zip                  |    11691-4551
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    Country              |    US
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    Telephone            |    844-370-6199
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    Fax                  |    347-222-3198
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Provider Business Mailing Address
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    Address Line         |    320 S POLK ST STE 200 
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    City                 |    AMARILLO
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    State                |    TX
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    Zip                  |    79101-1436
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    Country              |    US
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    Telephone            |    806-242-7782
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    Fax                  |    806-324-5495
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Authorized Official
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    Title or Position    |    PRESIDENT PHARMACY SERVICES
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    Name                 |     JOEL  WRIGHT 
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    Credential           |    
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    Telephone            |    806-242-7782
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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       |    
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    License Number State |    
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