PREMIUM PHARMA, LLC (NPI# 1578052312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578052312 |
| Entity Type | Organization |
| Organization Name | PREMIUM PHARMA, LLC |
| Other Organization Name | THE PHARMACY AT BERGHEIM |
| Practice Address |
1 Fm 3351 S Ste 115 Boerne TX 78006 |
| Mailing Address |
1 Fm 3351 S Ste 115 Boerne TX 78006-5729 |
| Practice Telephone | 8303362882 |
| Practice Fax Number | 8303362883 |
| Mailing Telephone | 8303362882 |
| Mailing Fax Number | 8303362883 |
| Enumeration Date | 2018-05-08 |
| Last Update Date | 2018-11-15 |
| Authorized Official Name | DUDLEY KLATT (VP OF OPERATIONS) |
| Authorized Official Telephone | 3612270412 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
31977 | TX | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2177272 | 01 |
| Other Name | Type Code |
|---|---|
| Premium Pharma | Doing Business As Name - Organization |
| The Pharmacy at Bergheim | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4503 De Zavala Rd Ste 112, San Antonio, TX 782492060 | 2103325900 | 2103325400 |
| Street Address |
1 FM 3351 S STE 115 |
| City | BOERNE |
| State | TX |
| Zip Code | 78006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982218517 | Boerne Mens Clinic | Family Medicine | 138 Tx-46, Boerne, TX 78006 | 2020-09-01 |
| 1700431798 | Methodist Ambulatory Surgery Center of Boerne, LLC | Clinic/Center | 110 Menger Springs, Boerne, TX 78006 | 2019-08-06 |
| 1144704156 | Lauren Elizabeth Settle | Counselor | 26254 Interstate 10, Suite 224, Boerne, TX 78006 | 2018-09-17 |
| 1265914600 | Shana North | Physical Therapy Assistant | 200 Ryan Street, Boerne, TX 78006 | 2018-09-02 |
| 1598258352 | Alamo Prosthetics LLC | Durable Medical Equipment & Medical Supplies | 28711 I 10 W, Boerne, TX 78006 | 2018-06-07 |
| 1952814386 | Advanced Surgical Care of Boerne, LLC | Clinic/Center | 138 Old San Antonio Rd # 400, Boerne, TX 78006 | 2017-11-07 |
| 1184151532 | River Road Pharmacy | Pharmacy | 910 River Rd Ste 103, Boerne, TX 78006 | 2017-05-16 |
| 1487191565 | Olive Branch Hope Center, Inc | Counselor | 215 W Bandera Rd 114 Pmb 239, Boerne, TX 78006 | 2017-01-26 |
| 1063955367 | Leigh Ann Grasso | Pharmacist | 31007 Ih 10 W, Ste 108, Boerne, TX 78006 | 2016-11-18 |
| 1700331436 | Markay Wilson Fluitt | Physician Assistant | 1201 S Main St Ste 114, Boerne, TX 78006 | 2016-08-23 |
| Find all providers in zip 78006 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164903704 | Annie's Apothecary, LLC | Pharmacy | 211 S Saunders St Unit 1, Boerne, TX 78006-2323 | 2018-08-22 |
| 1184151532 | River Road Pharmacy | Pharmacy | 910 River Rd Ste 103, Boerne, TX 78006 | 2017-05-16 |
| 1811184468 | Grasso Enterprises LLC | Pharmacy | 31007 Interstate 10 W, St 108, Boerne, TX 78006-9264 | 2007-09-27 |
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| 1629679717 | Edith Achebodt | Pharmacy | 2233 Avenue J Ste 103b, Arlington, TX 76006-5884 | 2020-11-04 |
| 1356942767 | Rxassist Pharmacy, Inc. | Pharmacy | 17020 Beaver Springs Dr Ste 8, Houston, TX 77090-2398 | 2020-11-03 |
| 1154921864 | Mbepe Health LLC | Pharmacy | 301 S 9th St Ste 121, Richmond, TX 77469-3448 | 2020-10-30 |
| 1639779366 | Mens African Investors | Pharmacy | 6355 S Peek Rd Ste 300, Katy, TX 77450-7195 | 2020-10-30 |
| 1861091977 | A Medizona Pharmacy | Pharmacy | 3700 Barker Cypress Rd, Suite 700, Houston, TX 77084 | 2020-10-20 |
| 1952900078 | Nudo Pharmacy LLC | Pharmacy | 104 Industrial Blvd Ste 201, Sugar Land, TX 77478-3174 | 2020-10-20 |
| 1194324277 | Rite Scripts Pharmacy Inc | Pharmacy | 13835 Westhollow Park Dr Apt 2805, Houston, TX 77082-1885 | 2020-10-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.