Premier Drugstore LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHRE010286 Issued in GA

Legal business name

PREMIER DRUGSTORE LLC

Doing business as

Premier Drugstore

Practice address

8446 Campbellton St
Douglasville, GA 30134-1803

Phone

(770) 635-8509

Fax

(770) 675-7296

NPI assigned

Apr 23, 2016

Last updated

Apr 17, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bryan GreenNPI 1730776899

Title

Pic/Pharmacist

Phone

(678) 481-0925

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Premier Drugstore Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bryan Green, PHARMD

  • Pharmacist
  • Douglasville, GA
  • NPI 1730776899
  NPD Authorized official
• Brenda A Kiger

  • Pharmacist
  • Douglasville, GA
  • NPI 1023605961
  NPD (past)

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

{
    "created_epoch": "1461369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492387200000",
    "number": "1114372448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8446 CAMPBELLTON ST",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301341803",
            "telephone_number": "770-635-8509",
            "fax_number": "770-675-7296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8446 CAMPBELLTON ST",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301341803",
            "telephone_number": "770-635-8509",
            "fax_number": "770-675-7296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER DRUGSTORE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-23",
        "last_updated": "2017-04-17",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "PIC/PHARMACIST",
        "authorized_official_telephone_number": "678-481-0925"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE010286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0037175653A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2159731",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Drugstore",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Olivia Power, PT, DPT
• Practitoners Community Care
• Cindy Pratt, MD
• Precious Hearts Transportation, LLC
• Preferred Private Home Care LLC
• Premier Geriatric Eyecare Incorporated
• Premier Healthcare Solutions
• Premise Health of Georgia Medical, P.C. (City of Douglasville)
• Marcia Anne Prescott, PHD
• Presley Home Care LLC

• Community/Retail Pharmacy in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Community/Retail Pharmacy in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.