Prem Pharmacy Corp.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

030790 Issued in NY

Legal business name

PREM PHARMACY CORP.

Practice address

5812 8TH Ave
Brooklyn, NY 11220-3979

Phone

(718) 484-4628

Fax

(718) 484-4630

NPI assigned

Mar 18, 2011

Organization subpart

No

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

Authorized official

Name

Ms. Susana Jiang

Title

President

Phone

(917) 992-2368

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Premium Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1300406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701907200000",
    "number": "1114226008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5812 8TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203979",
            "telephone_number": "718-484-4628",
            "fax_number": "718-484-4630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5812 8TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112203979",
            "telephone_number": "718-484-4628",
            "fax_number": "718-484-4630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREM PHARMACY CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-18",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A",
        "authorized_official_last_name": "JIANG",
        "authorized_official_first_name": "SUSANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-992-2368",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "030790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03319844",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "5803247",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premium Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Premium Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Devorah Preisler
• Roberta Preisler, PH D
• Irene R Preiss, LMHC
• Rachel Preizler, RDN, CDN
• Prem K Gupta MD PC
• Premed Pharmacy Inc
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• Premier Medical for Sport & Rehabilitation, P.C.

• Community/Retail Pharmacy in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.