Organization Name: | PREMIER PHARMACEUTICAL SERVICES, LLC |
NPI Number: | 1356401491 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GARY RUSSELL JOHNSON (OWNER) |
Mailing Address: | 1348 Us Highway 61 S Woodville |
State: | MS US |
Postal Code: | 396694560 |
Phone Number: | 6018887176 |
Fax Number: | 6018887134 |
NPI Enumeration Date: | 12/11/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BX2000X |
License Number: | 05058 11.1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Oxygen Equipment & Supplies |
Taxonomy Definition: |