Organization
PREMIER DRUGSTORE LLC
Active
Other names
Premier Drugstore
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN GREEN (PIC/PHARMACIST)
(678) 481-0925
Entity
Organization
Contact information
Practice address
8446 CAMPBELLTON ST, DOUGLASVILLE, GA 30134-1803
(770) 635-8509
(770) 675-7296
Mailing address
8446 CAMPBELLTON ST, DOUGLASVILLE, GA 30134-1803
(770) 635-8509
(770) 675-7296
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHRE010286
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0037175653A
—
GA
01
—
2159731
PK
—
Enumeration date
04/23/2016
Last updated
04/17/2017
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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