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NPI Code Detail

MEDICARE: PREMIER COMMUNITY HEALTH CARE GROUP, INC.

MEDICARE: PREMIER COMMUNITY HEALTH CARE GROUP, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0003XCommunity/Retail Pharmacy
2333600000XPharmacy

General Provider Information

NPI Number : 1558138149
Entity Type Code : Organization
Provider Name (Legal Business Name) : PREMIER COMMUNITY HEALTH CARE GROUP, INC.
Provider Business Mailing Address
First Line : PO BOX 232
Second Line :
City : DADE CITY
State : FL
Zip : 33526-0232
Country : US
Telephone Number : 352-518-2000
Fax Number : 352-567-0218
Provider Business Practice Location Address
First Line : 5957 ROWAN RD
Second Line :
City : NEW PORT RICHEY
State : FL
Zip : 34653-4531
Country : US
Telephone Number : 352-518-2000
Fax Number :
Authorized Official
Title or Position : CEO
Name : JOSEPH RESNICK
Credential :
Telephone Number : 352-518-2000
Provider Enumeration Date : 12/05/2023
Last Update Date : 12/05/2024

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