Organization
PREMIER SPECIALTY PHARMACY LLC
Active
Other names
Premier Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
POLINA POLIAKOVA (PIC)
(201) 683-8647
Entity
Organization
Contact information
Practice address
101 PARK AVE, STE 2, HOBOKEN, NJ 07030-3795
(201) 683-8647
(201) 683-8648
Mailing address
101 PARK AVE, STE 2, HOBOKEN, NJ 07030-3795
(201) 683-8647
(201) 683-8648
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
28RS00751600
NJ
3336C0003X
Community/Retail Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2164428
PK
—
Enumeration date
09/01/2016
Last updated
04/11/2017
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