Premium Pharmacy Services, Inc.

Primary specialty

PharmacyTaxonomy code 333600000X

License

22238 Issued in TX

Legal business name

PREMIUM PHARMACY SERVICES, INC.

Practice address

2805 W Arkansas LN
Suite 303
Arlington, TX 76016-5725

Phone

(817) 277-0405

Fax

(817) 277-0406

NPI assigned

Aug 11, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Ayesha Siddiqi

Title

Accounts Coordinator

Phone

(817) 784-2400

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174525075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 TECH CENTRE PKWY",
            "address_2": "SUITE 110",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760144405",
            "telephone_number": "817-784-2400",
            "fax_number": "817-676-9148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 W ARKANSAS LN",
            "address_2": "SUITE 303",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760165725",
            "telephone_number": "817-277-0405",
            "fax_number": "817-277-0406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM PHARMACY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SIDDIQI",
        "authorized_official_first_name": "AYESHA",
        "authorized_official_title_or_position": "ACCOUNTS COORDINATOR",
        "authorized_official_telephone_number": "817-784-2400",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TX",
            "license": "22238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4537974",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pharmacy in Arlington, TX
• Providers in Arlington, TX by specialty
• Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.