Provider Demographics
NPI:1932772613
Name:PREMIUM HEALTHCARE, LLC
Entity Type:Organization
Organization Name:PREMIUM HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:SCHINDELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:305-413-5070
Mailing Address - Street 1:2400 SW 69TH AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-2947
Mailing Address - Country:US
Mailing Address - Phone:305-413-5070
Mailing Address - Fax:305-859-3482
Practice Address - Street 1:2400 SW 69TH AVE STE 120
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-2947
Practice Address - Country:US
Practice Address - Phone:305-413-5070
Practice Address - Fax:305-859-3482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPH33479Medicaid
FLPH33479OtherINSURANCE PROVIDERS