Premier Pharmacy and Wellness Center LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

12668 Issued in NC

Legal business name

PREMIER PHARMACY AND WELLNESS CENTER LLC

Practice address

3010 Monroe Rd
Suite 101
Charlotte, NC 28205-7532

Phone

(772) 834-4707

NPI assigned

Jun 17, 2015

Last updated

Jul 13, 2022By 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

Dr. Martez Lavard Prince, PHARMDNPI 1407158629

Title

Owner/Pharmacymanager

Phone

(704) 940-0637

Specialties & licenses 1

Addresses

Other names 1

• Premier Pharmacy Other name

Medicare fee-for-service enrollment

Enrolled in NC2 enrollments

Enrollment records 2

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.

• Martez Lavard Prince, PHARM.D.

  • Pharmacist
  • Charlotte, NC
  • NPI 1407158629
  Authorized official Same address or phone

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657670400000",
    "number": "1568843241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 MONROE RD STE 101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282057533",
            "telephone_number": "704-496-9182",
            "fax_number": "704-496-9903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 MONROE RD",
            "address_2": "SUITE 101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282057532",
            "telephone_number": "772-834-4707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PHARMACY AND WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-17",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A",
        "authorized_official_last_name": "PRINCE",
        "authorized_official_first_name": "MARTEZ",
        "authorized_official_middle_name": "LAVARD",
        "authorized_official_title_or_position": "OWNER/PHARMACYMANAGER",
        "authorized_official_telephone_number": "704-940-0637",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "12668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Pharmacy",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Premier Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Premier Healthcare Staffing, LLC
• Premier Home Health Care Services, Inc.
• Premier Home Health Care Services, Inc.
• Premier Imaging Group, P.a.
• Premier Nursing Staffing Agency LLC
• Premier Pharmacy and Wellness Center LLC
• Premier Sleep and Neurology
• Premier Sleep Services, LLC
• Premier Spine Pain & Rehabilitation
• Premiere Speech Therapy Services, Inc.

• Community/Retail Pharmacy in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.