Organization
PREMIER IV CARE INC.
Active
Other names
NATIONS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VERN A ALLEN RPH (PRESIDENT)
(352) 597-4950
Entity
Organization
Contact information
Practice address
8269 COMMERCIAL WAY, WEEKI WACHEE, FL 34613-4511
(352) 597-4950
(352) 597-4553
Mailing address
PO BOX 6510, SPRING HILL, FL 34611-6510
(352) 597-4950
(352) 597-4553
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PH11651
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
297564
HIGHMARK BLUE SHIELD
FL
01
—
501235
FEDERAL BLACK LUNG PROGRA
FL
01
—
P6241
BC BS OF FLORIDA
FL
Enumeration date
06/23/2005
Last updated
08/22/2020
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