PREMIER COMPOUNDING CENTER LLC (NPI# 1659761914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659761914 |
| Entity Type | Organization |
| Organization Name | PREMIER COMPOUNDING CENTER LLC |
| Other Organization Name | PREMIER COMPOUNDING CENTER |
| Practice Address |
137 Chase Rd Portsmouth RI 02871-3243 |
| Practice Telephone | 4012933999 |
| Practice Fax Number | 4012933912 |
| Mailing Telephone | 4012933999 |
| Mailing Fax Number | 4012933912 |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2016-08-12 |
| Authorized Official Name | RENE ST. LAURENT (OWNER) |
| Authorized Official Telephone | 4012933999 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
PHA00567 | RI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2149794 | 01 |
| Other Name | Type Code |
|---|---|
| Premier Compounding Center | Doing Business As Name - Organization |
| Street Address |
137 CHASE RD |
| City | PORTSMOUTH |
| State | RI |
| Zip Code | 02871-3243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487028783 | Jocelyn Arruda | Marriage & Family Therapist | 275 Mccorrie Lane, Portsmouth, RI 02871 | 2015-11-24 |
| 1841587417 | Visiting Nurse Services of Newport and Bristol Counties | Clinic/Center | 1184 East Main Road, Portsmouth, RI 02871 | 2011-07-05 |
| 1831483148 | James Patrick Nolan | Pathology | 150 Carnegie Harbor Drive, Portsmouth, RI 02871 | 2011-06-03 |
| 1720378623 | Thomas Francis Reitano | Pharmacist | 3034 East Main Rd, Portsmouth, RI 02871 | 2011-04-12 |
| 1063716793 | Amber Kaltenstein | Psychologist | 2820 E Main Rd, Portsmouth, RI 02871 | 2011-01-10 |
| 1760660773 | Susan Mandrachia Killebrew | Social Worker | 107 Clock Tower Square, Portsmouth, RI 02871 | 2008-02-01 |
| 1235348335 | East Bay Endoscopy Center LLC | Clinic/Center | 109 Clock Tower Square, Portsmouth, RI 02871 | 2007-05-22 |
| 1346369147 | Todd Matthew Carbone | Physical Therapy Assistant | 459 Wapping Rd, Portsmouth, RI 02871 | 2007-03-29 |
| 1952436032 | Newport County Regional Special Education | Local Education Agency (LEA) | Elmhurst School, 1 Frank Coelho Drive, Portsmouth, RI 02871 | 2007-02-22 |
| 1437292760 | Aquidneck Dental, Inc. | Dentist | 21 King Charles Drive, Portsmouth, RI 02871 | 2007-02-15 |
| Find all providers in zip 02871 | ||||
| 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 |
|---|---|---|---|---|
| 1215353586 | Phusion Rx #102, LLC | Pharmacy | 42 Ladd St, Unit #208, East Greenwich, RI 02818-4361 | 2014-03-11 |
| 1649608696 | Prescription Compounding Specialists of Ri, Inc. | Pharmacy | 1145 Reservoir Ave, Suite 116, Cranston, RI 02920-6055 | 2013-10-29 |
| 1790076651 | Apothaca, Inc. | Pharmacy | 17 Coventry Shoppers Park, Coventry, RI 02816-5702 | 2011-04-27 |
| 1861622581 | New England Home Infusion Inc | Pharmacy | 3303 S County Trl, E Greenwich, RI 02818-1434 | 2009-07-15 |
| 1043343411 | Pawtuxet Valley Prescription & Surgical Center,inc | Pharmacy | 59 Sandy Bottom Rd, Coventry, RI 02816-5863 | 2007-03-14 |
| City | PORTSMOUTH |
| Zip Code | 02871 |
Please comment or provide details below to improve the information on PREMIER COMPOUNDING CENTER LLC.
| 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.