Provider Demographics
NPI:1356842181
Name:AMERICAN PREMIER PHARMACY LLC
Entity Type:Organization
Organization Name:AMERICAN PREMIER PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GUY
Authorized Official - Middle Name:SIMON FRASER
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:602-795-8664
Mailing Address - Street 1:11070 N 24TH AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-4705
Mailing Address - Country:US
Mailing Address - Phone:602-795-8664
Mailing Address - Fax:602-795-8665
Practice Address - Street 1:11070 N 24TH AVE STE 150
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-4705
Practice Address - Country:US
Practice Address - Phone:602-795-8664
Practice Address - Fax:602-795-8665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-27
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No251F00000XAgenciesHome Infusion
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy