Provider Demographics
NPI:1477027852
Name:PREMIER PHARMACY LLC
Entity Type:Organization
Organization Name:PREMIER PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:O'MEARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-328-5134
Mailing Address - Street 1:53 STILES RD STE B102
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-2890
Mailing Address - Country:US
Mailing Address - Phone:603-328-5134
Mailing Address - Fax:
Practice Address - Street 1:53 STILES RD STE B102
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2890
Practice Address - Country:US
Practice Address - Phone:603-328-5134
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-18
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy