PREMIER COMPOUNDING PHARMACY INC (NPI# 1609032259) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609032259 |
| Entity Type | Organization |
| Organization Name | PREMIER COMPOUNDING PHARMACY INC |
| Other Organization Name | PREMIER CUSTOM PHARMACY |
| Practice Address |
2000 Pga Blvd Ste 5507 Ste 5507 Palm Beach Gardens FL 33408-2726 |
| Mailing Address |
2000 Pga Blvd Ste 5507 Palm Beach Gardens FL 33408-2722 |
| Practice Telephone | 5616914991 |
| Practice Fax Number | 5616914998 |
| Mailing Telephone | 5616914991 |
| Mailing Fax Number | 5616914998 |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2016-06-16 |
| Authorized Official Name | TRACY CHRISTIAN (PRES) |
| Authorized Official Telephone | 5616914991 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
PH23481 | FL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 002422000 | 05 | |
| PK | 2116428 | 01 |
| Other Name | Type Code |
|---|---|
| Premier Custom Pharmacy | Doing Business As Name - Organization |
| Street Address |
2000 PGA BLVD STE 5507 STE 5507 |
| City | PALM BEACH GARDENS |
| State | FL |
| Zip Code | 33408-2726 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740880624 | Tracy Christian | Pharmacist | 2000 Pga Blvd Ste 5507, Palm Beach Gardens, FL 33408-2726 | 2020-10-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306457585 | Naomi Bollaci | Pharmacist | 314 Northlake Blvd, North Palm Beach, FL 33408 | 2020-08-12 |
| 1740750306 | Dihana C Ruiz | Nurse Practitioner | 631 Us Highway One Suite 309, North Palm Beach, FL 33408 | 2018-11-27 |
| 1487121117 | Chancellor Medical | Durable Medical Equipment & Medical Supplies | 1224 N. Federal Highway, Suite D, North Palm Beach, FL 33408 | 2018-10-31 |
| 1538679535 | Jennifer Guldager | Physician Assistant | 11951 Us Highway 1 Ste 108, North Palm Beach, FL 33408 | 2017-10-04 |
| 1134646581 | Live Now Physical Therapy Inc. | Clinic/Center | 873 Fathom Rd W, North Palm Beach, FL 33408 | 2017-08-26 |
| 1912424573 | Magdalena Orosz | Clinical Medical Laboratory | 20 Celestial Way #205, Juno Beach, FL 33408 | 2017-08-24 |
| 1205377173 | Premier Compounding Pharmacy, Inc. | Pharmacy | 2000 Pga Blvd., Suite 5507, Palm Beach Gardens, FL 33408 | 2017-03-13 |
| 1841742160 | Anne Hart Rajawat | Speech-Language Pathologist | 1201 Us 1 Ste 210, North Palm Beach, FL 33408 | 2016-11-03 |
| 1801342605 | Lindsey Kelly | Occupational Therapist | 1201 U.S. Highway One, Suite 215, North Palm Beach, FL 33408 | 2016-08-31 |
| 1346694205 | Stephanie Lynch Therapy Inc. | Counselor | 513 Us Hwy #1, 213, North Palm Beach, FL 33408 | 2016-04-18 |
| Find all providers in zip 33408 | ||||
| Taxonomy Code | 3336C0004X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Compounding Pharmacy |
| A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner’s Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice. |
| Notes: Sources: NABP Model Practice Act, Appendix C - Good Compounding Practice, USP <795> and <797>, and Pharmacy Compounding Accreditation Board [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770714867 | Anthony's Drugs, Inc. | Pharmacy | 9121 N Military Trl Ste 106, Palm Beach Gardens, FL 33410-5985 | 2009-08-06 |
| 1013348564 | Darjen, Inc | Pharmacy | 10358 Riverside Dr Ste 140, Palm Beach Gardens, FL 33410-4203 | 2013-12-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508473414 | Tu Te Wellness Pharmacy LLC | Pharmacy | 8563 Argyle Business Loop Ste 1, Jacksonville, FL 32244-6613 | 2020-09-24 |
| 1467068197 | Avm Compounding Pharmacy LLC | Pharmacy | 501 S Lincoln Ave Ste 203, Clearwater, FL 33756-5945 | 2020-09-18 |
| 1376151423 | 1st America Infusion Services LLC | Pharmacy | 639 N Highway 231, Panama City, FL 32405-4704 | 2020-07-15 |
| 1114540416 | Ramzy's Mediterranean Cafe Pharmacy, Inc | Pharmacy | 8740 N Kendall Dr Ste 106, Miami, FL 33176-2209 | 2020-05-20 |
| 1023643707 | Ops International Incorporated | Pharmacy | 4600 L B Mcleod Rd, Orlando, FL 32811-6454 | 2020-03-03 |
| 1639709454 | Medstop | Pharmacy | 2095 W Fairbanks Ave, Winter Park, FL 32789-4543 | 2020-01-21 |
| 1922644491 | My Prescription Coach, LLC | Pharmacy | 5008 W. Linebaugh Avenue, Suites 33 &34, Tampa, FL 33624-5038 | 2019-11-20 |
| 1346709540 | Pharmacygo, Inc | Pharmacy | 20041 S Tamiami Trl Ste 13, Estero, FL 33928-2228 | 2019-03-18 |
| 1124596150 | Rx for All Pharmacy Corp | Pharmacy | 1325 Nw 93rd Ct Ste B109, Doral, FL 33172-2835 | 2018-11-07 |
| 1710472451 | Caring Rx, LLC | Pharmacy | 21002 S Ridgewood Ave, Suite 2, Edgewater, FL 32141 | 2018-06-26 |
| Find all providers with the same taxonomy | ||||
| City | PALM BEACH GARDENS |
| Zip Code | 33408 |
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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.