Premier Community Health Care Group Inc
Organization Active NPI Clinic Pharmacy · Dode City, FL
NPI 1730125873 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1730125873
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic Pharmacy 3336C0002X
- License
- PH21294 (FL)
- Legal business name
- PREMIER COMMUNITY HEALTH CARE GROUP INC
- Practice address
- 14031 5TH St
Dode City, FL 33525 - Phone
- (352) 518-2000
- Fax
- (352) 521-3091
- NPI assigned
- Jun 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Donna B Delong
- Title
- Cfo
- Phone
- (352) 567-1087
Corporate family (same tax ID) 19
National Provider Directory
- Tax ID family
- Healthresource Alliance
Locations
14031 5th St
Dade City, FL 33525
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic Pharmacy | 3336C0002X | PH21294 | FL | Yes |
Addresses
Primary practice location
14031 5TH St
Dode City, FL 33525
Mailing address
PO Box 232
Dode City, FL 33526-0232
Phone (352) 518-2000
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.