# PREMIERE HEALTHCARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Medical Center Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811284060
- **Authorized official:** DR. PHILLIP K WILKINS SR. PHARM D. (OWNER/PHARMACIST)
- **Authorized official phone:** (573) 996-3784

## Contact information

- **Practice address:** 513B N GRAND AVE, DONIPHAN, MO 63935-1405
- **Practice address phone:** (573) 996-3784
- **Practice address fax:** (573) 996-5275
- **Mailing address:** 513B N GRAND AVE, DONIPHAN, MO 63935-1405
- **Mailing address phone:** (573) 996-3784
- **Mailing address fax:** (573) 996-5275

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 2010023102 | MO | Yes |

## Other

- **Enumeration date:** 07/07/2011
- **Last updated:** 07/07/2011