MEDICARE: PREMIERX PHARMACY 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
1	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912488586
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIERX PHARMACY INC.

Provider Business Mailing Address
First Line	:	3551 CLEVELAND AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-2909
Country	:	US
Telephone Number	:	614-924-2124
Fax Number	:	614-505-3093

Provider Business Practice Location Address
First Line	:	3551 CLEVELAND AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-2909
Country	:	US
Telephone Number	:	614-924-2124
Fax Number	:	614-505-3093

Authorized Official
Title or Position	:	PHARMACY MANAGER
Name	:	DR. UREJI AHMED
Credential	:
Telephone Number	:	614-924-2124

Provider Enumeration Date	:	08/22/2018
Last Update Date	:	06/18/2026

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