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Organization
PREMIER COMPOUNDING CENTER LLC
Active
Organization
PREMIER COMPOUNDING CENTER LLC
Active
Other names
Premier Compounding Center
Organization subpart
No
Provider details
NPI number
Authorized official
RENE ST. LAURENT (OWNER)
(401) 293-3999
Entity
Organization
Contact information
Practice address
137 CHASE RD, PORTSMOUTH, RI 02871-3243
(401) 293-3999
(401) 293-3912
Mailing address
137 CHASE RD, PORTSMOUTH, RI 02871-3243
(401) 293-3999
(401) 293-3912
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
PHA00567
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2149794
PK
—
Enumeration date
01/26/2015
Last updated
08/12/2016
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