Organization
PREMIER KIDS CARE, INC.
Active
Other names
Premier Care
Organization subpart
No
Provider details
NPI number
Authorized official
JOY A. CHESNUT RN (PRESIDENT/CEO)
(888) 892-9001
Entity
Organization
Contact information
Practice address
221 PLAZA DR, MONROE, GA 30655-3184
(888) 892-9001
(866) 810-4012
Mailing address
221 PLAZA DR, MONROE, GA 30655-3184
(888) 892-9001
(866) 810-4012
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHRE008225
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003139004
—
CT
05
—
00712401B
—
GA
05
—
100505768
—
NV
05
—
101129137-0002
—
PA
05
—
120590100
—
WY
05
—
1548237563
—
IA
05
—
1548237563
—
MI
05
—
1548237563
—
MT
05
—
1548237563
—
TN
05
—
1548237563
—
VT
05
—
1548237563
—
WA
05
—
200047110A
—
OK
05
—
200083690A
—
IN
05
—
200434700A
—
KS
05
—
20385765
—
NM
05
—
2536947
—
OH
05
—
274567
—
OR
05
—
4058372-00
—
MD
05
—
636645000
—
MN
05
—
7100019090
—
KY
05
—
7G8225
—
SC
05
—
807272000
—
ID
05
—
919730
—
AZ
Enumeration date
03/29/2012
Last updated
03/29/2012
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