Organization
PREMIER PHARMACY OF JACKSONVILLE INC
Active
Other names
PREMIER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNNY BATEH (PRESIDENT)
(904) 355-5646
Entity
Organization
Contact information
Practice address
150 E 8TH ST, JACKSONVILLE, FL 32206-3704
(904) 355-5646
(904) 355-6263
Mailing address
150 E 8TH ST, JACKSONVILLE, FL 32206-3704
(904) 355-5646
(904) 355-6263
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH15489
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106170400
—
FL
01
—
2010729
PK
—
Enumeration date
03/08/2007
Last updated
09/14/2016
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