Provider Demographics
NPI:1174841860
Name:PREMIER PHARMACY INTERNATIONAL, LP
Entity Type:Organization
Organization Name:PREMIER PHARMACY INTERNATIONAL, LP
Other - Org Name:HOTZE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMBRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:FOLSOM
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:281-698-8624
Mailing Address - Street 1:20214 BRAIDWOOD DR
Mailing Address - Street 2:SUITE 140
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-2138
Mailing Address - Country:US
Mailing Address - Phone:281-828-9088
Mailing Address - Fax:
Practice Address - Street 1:20214 BRAIDWOOD DR
Practice Address - Street 2:SUITE 140
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2138
Practice Address - Country:US
Practice Address - Phone:281-828-9088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-05
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18732183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty