Provider Demographics
NPI:1346739612
Name:GOOD HEALTH, INC. DBA PREMIER PHARMACY SERVICES
Entity Type:Organization
Organization Name:GOOD HEALTH, INC. DBA PREMIER PHARMACY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMUEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-869-2259
Mailing Address - Street 1:410 CLOVERLEAF DR
Mailing Address - Street 2:
Mailing Address - City:BALDWIN PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91706-6511
Mailing Address - Country:US
Mailing Address - Phone:626-626-9425
Mailing Address - Fax:
Practice Address - Street 1:711 ANDERSON AVE
Practice Address - Street 2:
Practice Address - City:CLIFFSIDE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07010-2032
Practice Address - Country:US
Practice Address - Phone:201-313-9797
Practice Address - Fax:201-313-9798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-02
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS007308003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy