# PREMIER COMPOUNDING PHARMACY INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Premier Custom Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609032259
- **Authorized official:** TRACY CHRISTIAN (PRES)
- **Authorized official phone:** (561) 691-4991

## Contact information

- **Practice address:** 2000 PGA BLVD STE 5507, STE 5507, PALM BEACH GARDENS, FL 33408-2726
- **Practice address phone:** (561) 691-4991
- **Practice address fax:** (561) 691-4998
- **Mailing address:** 2000 PGA BLVD, STE 5507, PALM BEACH GARDENS, FL 33408-2722
- **Mailing address phone:** (561) 691-4991
- **Mailing address fax:** (561) 691-4998

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |
| 3336C0004X | Compounding Pharmacy | PH23481 | FL | Yes |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 08/04/2008
- **Last updated:** 06/16/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 002422000 | — | FL |
| 01 | — | 2116428 | PK | — |