Premier Specialty Pharmacy LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

28RS00751600 Issued in NJ

Legal business name

PREMIER SPECIALTY PHARMACY LLC

Practice address

101 Park Ave
Ste 2
Hoboken, NJ 07030-3795

Phone

(201) 683-8647

Fax

(201) 683-8648

NPI assigned

Sep 1, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Polina Poliakova

Title

Pic

Phone

(201) 683-8647

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Premier Pharmacy Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491868800000",
    "number": "1073069779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PARK AVE",
            "address_2": "STE 2",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070303795",
            "telephone_number": "201-683-8647",
            "fax_number": "201-683-8648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PARK AVE",
            "address_2": "STE 2",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070303795",
            "telephone_number": "201-683-8647",
            "fax_number": "201-683-8648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER SPECIALTY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2017-04-11",
        "status": "A",
        "authorized_official_last_name": "POLIAKOVA",
        "authorized_official_first_name": "POLINA",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "201-683-8647"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NJ",
            "license": "28RS00751600",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2164428",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacy in Hoboken, NJ
• Providers in Hoboken, NJ by specialty
• Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.