Organization
PREMIER PHARMACY LLC
Active
Other names
Premier Pharmacy LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MIROSLAV KESIC (PRESIDENT)
(484) 270-6501
Entity
Organization
Contact information
Practice address
150 MONUMENT RD STE 601A, BALA CYNWYD, PA 19004-1701
(484) 270-6501
Mailing address
150 MONUMENT RD, SUITE 601A, BALA CYNWYD, PA 19004-1702
(484) 270-6501
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PP482598
PA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2155178
PK
—
Enumeration date
10/30/2015
Last updated
11/18/2015
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