Organization
PREMIER PHARMACY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN CORRESSELL RPH (COO/PHARMACY DIRECTOR)
(812) 430-0192
Entity
Organization
Contact information
Practice address
600 CORPORATION DR STE 114, PENDLETON, IN 46064-8300
(833) 464-9129
Mailing address
9656 PRAIRIE SMOKE DR, NOBLESVILLE, IN 46060-4307
(812) 430-0192
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
11/07/2022
Last updated
11/07/2022
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