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General NPI Number Information
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NPI Number | 1871280933
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Entity Type | Organization
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Legal Business Name | PREMIER PHARMACY NORCAL LLC
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Dates
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Enumeration Date | 04/19/2023
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Last Update Date | 09/12/2023
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Provider Practice Location Address
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Address Line | 4600 NORTHGATE BLVD STE 120
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City | SACRAMENTO
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State | CA
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Zip | 95834-1159
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Country | US
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Telephone | 661-445-9617
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Fax |
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Provider Business Mailing Address
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Address Line | 4600 NORTHGATE BLVD STE 120
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City | SACRAMENTO
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State | CA
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Zip | 95834-1159
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF LTC
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Name | NADINE JARJUR
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Credential | PHARMD, MBA
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Telephone | 916-520-0934
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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 | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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