NPIMap

Organization Active NPI

Premiere Healthcare LLC

Doing business as Medical Center Pharmacy

  • Durable Medical Equipment & Medical Supplies
  • Doniphan, MO
National Provider Identifier
1215258652
Registry record updated Nov 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
PREMIERE HEALTHCARE LLC
Doing business as
Medical Center Pharmacy
Practice address
513 N Grand Ave
Doniphan, MO 63935-1405
Phone
(573) 996-3784
NPI assigned
Jun 21, 2010
Last updated
Nov 5, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2010

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

Authorized official

Name
Mr. Phillip Keith Wilkins Sr.NPI 1700173051
Title
Pharmacy Owner
Phone
(870) 931-9263

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Customized Equipment (DME) 332BC3200X
Dialysis Equipment & Supplies (DME) 332BD1200X
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X
Oxygen Equipment & Supplies (DME) 332BX2000X

Addresses

Primary practice location

513 N Grand Ave
Doniphan, MO 63935-1405

Mailing address

513 N Grand Ave
Doniphan, MO 63935-1405
Phone (573) 996-3784

Other names 1

  • Medical Center Pharmacy Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1277078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288915200000",
    "number": "1215258652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 N GRAND AVE",
            "city": "DONIPHAN",
            "state": "MO",
            "postal_code": "639351405",
            "telephone_number": "573-996-3784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 N GRAND AVE",
            "city": "DONIPHAN",
            "state": "MO",
            "postal_code": "639351405",
            "telephone_number": "573-996-3784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIERE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-21",
        "last_updated": "2010-11-05",
        "status": "A",
        "authorized_official_last_name": "WILKINS",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "PHARMACY OWNER",
        "authorized_official_telephone_number": "870-931-9263",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BD1200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Doniphan, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2010; 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.