Organization
PREM PHARMACY CORP.
Active
Other names
Premium Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSANA JIANG (PRESIDENT)
(917) 992-2368
Entity
Organization
Contact information
Practice address
5812 8TH AVE, BROOKLYN, NY 11220-3979
(718) 484-4628
(718) 484-4630
Mailing address
5812 8TH AVE, BROOKLYN, NY 11220-3979
(718) 484-4628
(718) 484-4630
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
030790
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03319844
—
NY
01
—
5803247
NCPDP
—
Enumeration date
03/18/2011
Last updated
12/07/2023
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