Organization Active NPI

Premium Med Pharmacy LLC

  • Pharmacy
  • Modesto, CA
National Provider Identifier
1326837303
Registry record updated May 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
PREMIUM MED PHARMACY LLC
Practice address
3121 Yosemite Blvd Ste A2
Modesto, CA 95354-4167
Phone
(209) 222-3029
NPI assigned
May 5, 2025
Last updated
May 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2025

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

Authorized official

Name
Amara Afzal
Title
Member
Phone
(916) 225-2837

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

3121 Yosemite Blvd Ste A2
Modesto, CA 95354-4167

Mailing address

3121 Yosemite Blvd Ste A2
Modesto, CA 95354-4167

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251107004759 CA Part B Supplier - Pharmacy 1850881764 Practice locations: Modesto, CA

National Provider Directory

National Provider Directory

Locations

3121 Yosemite Blvd
Ste A2
Modesto, CA 95354
Phone (209) 222-3029

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": "1746403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746403200000",
    "number": "1326837303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3121 YOSEMITE BLVD STE A2",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953544167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3121 YOSEMITE BLVD STE A2",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953544167",
            "telephone_number": "209-222-3029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM MED PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-05",
        "last_updated": "2025-05-05",
        "certification_date": "2025-05-05",
        "status": "A",
        "authorized_official_last_name": "AFZAL",
        "authorized_official_first_name": "AMARA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "916-225-2837"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2025; 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.