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Organization
PREMIER SPECIALTY PHARMACY LLC
Active
Organization
PREMIER SPECIALTY PHARMACY LLC
Active
Other names
Premier Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BUFFY GOUGELMANN (PHARMACIST IN CHARGE)
(770) 622-8901
Entity
Organization
Contact information
Practice address
11720 MEDLOCK BRIDGE RD STE 162, JOHNS CREEK, GA 30097-1513
(770) 622-8901
(770) 622-8900
Mailing address
335 LUM CROWE RD, ROSWELL, GA 30075-6879
(678) 478-8019
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
PHRE010313
GA
3336C0004X
Compounding Pharmacy
—
NULL
Other
Enumeration date
09/16/2016
Last updated
02/21/2017
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