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Organization

PREMIER COMPOUNDING CENTER LLC

Active
Other names
Premier Compounding Center
Organization subpart
No

Provider details

NPI number
Authorized official
RENE ST. LAURENT (OWNER)
(401) 293-3999
Entity
Organization

Contact information

Practice address
137 CHASE RD, PORTSMOUTH, RI 02871-3243
(401) 293-3999
(401) 293-3912
Mailing address
137 CHASE RD, PORTSMOUTH, RI 02871-3243
(401) 293-3999
(401) 293-3912

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
3336C0004X
Compounding Pharmacy
Primary
PHA00567
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2149794
PK
Enumeration date
01/26/2015
Last updated
08/12/2016
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