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PREMIER COMPOUNDING PHARMACY INC NPI 1609032259


NPI Information

NPI: 1609032259
Provider Name: PREMIER COMPOUNDING PHARMACY INC

Doing Business As: PREMIER CUSTOM PHARMACY

Classification: Pharmacy - 3336C0004X
Entity Type: Organization

Specialization: Compounding Pharmacy

CLIA Number: 10D2191546

Address:
2000 PGA BLVD STE 5507
STE 5507
PALM BEACH GARDENS, FL
ZIP 33408
Phone: (561) 691-4991
Get Directions

PREMIER COMPOUNDING PHARMACY INC is a compounding pharmacy pharmacy in Palm Beach Gardens, FL. The provider is a pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice. PREMIER COMPOUNDING PHARMACY INC NPI is 1609032259. The provider is registered as an organization entity type.
The provider Is Doing Business As Premier Custom Pharmacy.

The provider's business location address is:

2000 PGA BLVD STE 5507
STE 5507
PALM BEACH GARDENS, FL
ZIP 33408-726
Phone: (561) 691-4991
Fax: (561) 691-4998

The provider's authorized official is Tracy Christian .
The authorized official title is Pres and has the following contact phone number (561) 691-4991.

The CLIA number assigned to this NPI record is 10D2191546 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/4/2008 and was last updated on 6/16/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13336C0003XPharmacyCommunity/Retail PharmacyNo
23336S0011XPharmacySpecialty PharmacyNo
3333600000XPharmacyNo
43336C0004XPharmacyCompounding PharmacyPH23481FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1002422000MEDICAIDFLORIDA
22116428OTHERPK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.