Organization
PREMIER MED SERVICES INC
Active
Other names
PREMIER MED SERVICES INC
Organization subpart
No
Provider details
NPI number
Authorized official
DEYDA CUELLAR (OFFICE MANAGER)
(855) 258-6352
Entity
Organization
Contact information
Practice address
11207 S LA CIENEGA BLVD STE 102, LOS ANGELES, CA 90045-6112
(855) 258-6352
(855) 258-6353
Mailing address
11207 S LA CIENEGA BLVD, SUITE 102, LOS ANGELES, CA 90045-6112
(855) 258-6352
(855) 258-6353
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY50857
CA
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2135435
PK
—
Enumeration date
05/31/2012
Last updated
05/20/2015
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