Organization
BLKC, INC. (D/B/A PREMIER COMPOUNDING PHARMACY)
Active
Other names
Premier Compounding Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM A LIPIRA (PRESIDENT/PHARMACIST)
(816) 279-6700
Entity
Organization
Contact information
Practice address
1427 VILLAGE DR, SAINT JOSEPH, MO 64506-2459
(816) 279-6700
(816) 279-5603
Mailing address
1427 VILLAGE DR, SAINT JOSEPH, MO 64506-2459
(816) 279-6700
(816) 279-5603
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
041133
MO
333600000X
Pharmacy
006462
MO
333600000X
Pharmacy
Primary
2013022132
MO
Other
Enumeration date
01/23/2007
Last updated
02/04/2014
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