Organization
PREMIER FAMILY PHARMACY INC
Active
Other names
Premier Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BASSEL JOUDEH (PRESIDENT)
(708) 952-0000
Entity
Organization
Contact information
Practice address
5600 W 87TH ST STE B, BURBANK, IL 60459-2902
(708) 952-0000
(708) 598-0606
Mailing address
5600 W 87TH ST, SUITE B, BURBANK, IL 60459-2902
(708) 952-0000
(708) 598-0606
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054-018906
IL
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2149504
PK
—
Enumeration date
12/29/2014
Last updated
01/23/2015
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