Provider Demographics
NPI:1417904574
Name:PREMIER INFUSION AND HEALTHCARE SERVICES, INC.
Entity Type:Organization
Organization Name:PREMIER INFUSION AND HEALTHCARE SERVICES, INC.
Other - Org Name:PHARMACO, INC. DBA PREMIER INFUSION CARE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SINA
Authorized Official - Middle Name:MORDECHAI
Authorized Official - Last Name:REFUA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD,BCNSP
Authorized Official - Phone:866-365-2525
Mailing Address - Street 1:19500 NORMANDIE AVE
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-1108
Mailing Address - Country:US
Mailing Address - Phone:866-365-2525
Mailing Address - Fax:866-383-2525
Practice Address - Street 1:19500 NORMANDIE AVE
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-1108
Practice Address - Country:US
Practice Address - Phone:866-365-2525
Practice Address - Fax:866-383-2525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 332B00000X, 332BC3200X, 332BP3500X, 333600000X, 3336C0002X, 3336C0003X, 3336C0004X, 3336H0001X, 3336S0011X
CAPHY46682251F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion
No251E00000XAgenciesHome Health
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHA466820Medicaid
CAPHA466820Medicaid