PREMIER PHARMACY LLC (NPI# 1104338847) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104338847 |
| Entity Type | Organization |
| Organization Name | PREMIER PHARMACY LLC |
| Other Organization Name | PREMIER PHARMACY |
| Practice Address |
3550 Mckelvey Rd Suite 100b Bridgeton MO 63044-2527 |
| Practice Telephone | 3142869660 |
| Practice Fax Number | 3142189625 |
| Mailing Telephone | 3142869660 |
| Mailing Fax Number | 3142189625 |
| Enumeration Date | 2017-11-03 |
| Last Update Date | 2018-07-19 |
| Authorized Official Name | SAM BAE (OWNER) |
| Authorized Official Telephone | 3143249093 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
Suppliers | ||
| N | 3336M0002X |
Pharmacy Specialization: Mail Order Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
2018013917 | MO | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2172098 | 01 |
| Other Name | Type Code |
|---|---|
| Premier Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477027852 | Premier Pharmacy LLC | Pharmacy | 53 Stiles Rd Ste B102, Salem, NH 03079-2890 | 2019-01-18 |
| 1790157618 | Premier Pharmacy LLC | Pharmacy | 150 Monument Rd Ste 601a, Bala Cynwyd, PA 19004-1701 | 2015-10-30 |
| 1508195769 | Premier Pharmacy LLC | Pharmacy | 4307 N Armenia Ave, Tampa, FL 33607-6403 | 2009-12-17 |
| 1295016947 | Premier Pharmacy LLC | Pharmacy | 34025 Harper Ave, Clinton Township, MI 48035-3737 | 2011-09-07 |
| 1467758664 | Premier Pharmacy LLC | Pharmacy | 315 N Washington Ave, Suite 102, Cookeville, TN 38501-2603 | 2011-02-04 |
| Street Address |
3550 MCKELVEY RD SUITE 100B |
| City | BRIDGETON |
| State | MO |
| Zip Code | 63044-2527 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417351461 | Jessica Lee Roberts | Nurse Anesthetist, Certified Registered | 3550 Mckelvey Rd, Bridgeton, MO 63044-2527 | 2014-10-20 |
| 1982160990 | Nickolas Rongey | Nurse Practitioner | 3550 Mckelvey Rd, Bridgeton, MO 63044-2527 | 2019-02-14 |
| 1609328798 | Jennifer Lee Fendler | Nurse Practitioner | 3550 Mckelvey Rd, Bridgeton, MO 63044-2535 | 2016-10-25 |
| 1447613344 | Premier Surgical Center LLC | Clinic/Center | 3550 Mckelvey Rd, Bridgeton, MO 63044-2527 | 2016-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073150017 | Zoe Marie Wadsworth | Nurse Practitioner | 12255 Depaul Dr Suite 300, Bridgeton, MO 63044 | 2019-12-10 |
| 1609412451 | Beyond Better, Best Home Health Care Services, Limited Liability Corpo | In Home Supportive Care | 3430 Mckelvey Road Ste B, Bridgeton, MO 63044 | 2019-11-26 |
| 1275189078 | Delicate Angels Home Health LLC | Home Health | 11726 St. Charles Rock Road Suite G, Bridgeton, MO 63044 | 2019-08-16 |
| 1588210082 | Nicholas Huber | Physical Therapist | 12349 Depaul Dr., Ste. 110, Bridgeton, MO 63044 | 2019-08-12 |
| 1124688858 | Michelle Bassett | Registered Nurse | 11520 St. Charles Rock Rd., Suite 106, Bridgeton, MO 63044 | 2019-06-14 |
| 1336703883 | Elena A Barrow | Nurse Practitioner | 12255 Depaul Dr, Suite 260, Bridgeton, MO 63044 | 2019-04-30 |
| 1487123105 | Laura N Steiner | Registered Nurse | Gateway Pediatrics, Ltd, 12255 Depaul Drive, Suite 460 North Medical Building, Bridgeton, MO 63044 | 2018-11-26 |
| 1205310950 | Danielle Mathis | Nurse Practitioner | 3440 Depaul Lane Suite 201, Bridgeton, MO 63044 | 2018-09-19 |
| 1588163570 | Thoughts Out Loud Counseling, LLC | Social Worker | 11520 St. Charles Rock Road Suite 101, Bridgeton, MO 63044 | 2018-02-06 |
| 1912411430 | Breanna Victoria Hayes | Counselor | 3165 Mckevley Road, Suite 200, Bridgeton, MO 63044 | 2017-11-20 |
| Find all providers in zip 63044 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538727185 | Bwell Pharmacy Bridgeton LLC | Pharmacy | 12158 Natural Bridge Rd Ste C, Bridgeton, MO 63044-4079 | 2019-05-30 |
| 1336485283 | Light Pharmacy LLC | Pharmacy | 212 Laurel Heights Dr, Bridgeton, NJ 08302-3634 | 2012-12-21 |
| 1538274311 | 4977, LLC | Pharmacy | 1000 N Pearl St, Bridgeton, NJ 08302-1215 | 2006-08-20 |
| 1073528964 | Walgreen Co | Pharmacy | 9 Landis Ave, Bridgeton, NJ 08302 | 2006-07-29 |
| 1750867636 | Samantha Nguyen | Pharmacy | 12921 Enterprise Way, Bridgeton, MO 63044-1206 | 2018-07-13 |
| 1841508041 | Schnuck Markets Inc | Pharmacy | 12921 Enterprise Way, Bridgeton, MO 63044-1206 | 2010-09-22 |
| 1235209032 | Ssm Health Care St. Louis | Pharmacy | 12255 De Paul Dr, Bridgeton, MO 63044-2510 | 2006-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699374629 | Curators of The University of Missouri | Pharmacy | 7115 East St. Charles Road, Columbia, MO 65202 | 2020-10-21 |
| 1376141143 | Phillips Pharmacy, LLC | Pharmacy | 7278 State Highway 14 E, Sparta, MO 65753-9345 | 2020-10-14 |
| 1013527761 | Rpcs, Inc. | Pharmacy | 18128 State Hwy 13, Branson West, MO 65737 | 2020-08-07 |
| 1205446184 | Rpcs, Inc. | Pharmacy | 200 Southtowne Blvd, Hollister, MO 65672-9610 | 2020-08-05 |
| 1912517897 | Rpcs, Inc. | Pharmacy | 1447 State Highway 248 Ste J, Branson, MO 65616-8161 | 2020-08-05 |
| 1245849801 | Rpcs Inc | Pharmacy | 163 W Old Mill Rd, Fair Grove, MO 65648-7918 | 2020-07-29 |
| 1760005219 | Meta Pharmacy Solutions | Pharmacy | 108 Triad Ctr W, O Fallon, MO 63366-7541 | 2020-05-19 |
| 1437778172 | Harps Food Stores, Inc | Pharmacy | 707 Specialty Dr, Dexter, MO 63841-2718 | 2020-04-13 |
| 1013540038 | Auburn Pharmacy Inc | Pharmacy | 810 W 35th St Ste 101, Higginsville, MO 64037-1865 | 2020-02-18 |
| 1801428495 | Scpg Missouri LLC | Pharmacy | 501 South Madison Ave, Suite S, Webb City, MO 64870 | 2020-02-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.