Organization
PREMIER COMPOUNDING PHARMACY, INC.
Active
Parent organization
PREMIER COMPOUNDING PHARMACY, INC.
Other names
Premier Pharmacy LTC, United LTC Rx
Organization subpart
Yes
Provider details
NPI number
Legal business name
PREMIER COMPOUNDING PHARMACY, INC.
Authorized official
TRACY CHRISTIAN RPH, OWNER (PRESIDENT/CEO/OWNER)
(888) 507-8621
Entity
Organization
Contact information
Practice address
2000 PGA BLVD., SUITE 5507, PALM BEACH GARDENS, FL 33408
(888) 507-8621
Mailing address
2000 PGA BLVD., SUITE 5507, PALM BEACH GARDENS, FL 33408
(888) 507-8621
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PH23481
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2168181
PK
—
Enumeration date
03/13/2017
Last updated
06/16/2018
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