PREMIERE HEALTHCARE LLC (NPI# 1639466881) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639466881 |
| Entity Type | Organization |
| Organization Name | PREMIERE HEALTHCARE LLC |
| Other Organization Name | MEDICAL CENTER PHARMACY |
| Practice Address |
513b N Grand Ave Doniphan MO 63935-1405 |
| Practice Telephone | 5739963784 |
| Practice Fax Number | 5739965275 |
| Mailing Telephone | 5739963784 |
| Mailing Fax Number | 5739965275 |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2011-07-07 |
| Authorized Official Name | DR. PHILLIP KEITH WILKINS SR. (OWNER/PHARMACIST) |
| Authorized Official Telephone | 5739963784 |
| Authorized Official Credential | PHARM D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | 2010023102 | MO | Suppliers |
| Other Name | Type Code |
|---|---|
| Medical Center Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770929366 | Premiere Healthcare LLC | Durable Medical Equipment & Medical Supplies | 214 W Main St, Malden, MO 63863-2114 | 2013-05-22 |
| 1811284060 | Premiere Healthcare LLC | Pharmacy | 513b N Grand Ave, Doniphan, MO 63935-1405 | 2011-07-07 |
| 1215258652 | Premiere Healthcare LLC | Durable Medical Equipment & Medical Supplies | 513 N Grand Ave, Doniphan, MO 63935-1405 | 2010-06-21 |
| 1225359664 | Premiere Healthcare LLC | Pharmacy | 513 N Grand Ave, Doniphan, MO 63935-1405 | 2010-06-21 |
| Street Address |
513B N GRAND AVE |
| City | DONIPHAN |
| State | MO |
| Zip Code | 63935-1405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316953987 | Osage Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 513b N Grand Ave, Doniphan, MO 63935-1405 | 2006-08-01 |
| 1700173051 | Phillip Wilkins Sr. | Pharmacist | 513b N Grand Ave, Doniphan, MO 63935-1405 | 2011-07-07 |
| 1811284060 | Premiere Healthcare LLC | Pharmacy | 513b N Grand Ave, Doniphan, MO 63935-1405 | 2011-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235647629 | Reorganized School Dist 4 | Local Education Agency (LEA) | Hcr 7, Box 51, Doniphan, MO 63935 | 2018-01-19 |
| 1144737206 | Amy Jo Harris | Licensed Practical Nurse | 209 W Highway St, Doniphan, MO 63935 | 2018-01-10 |
| 1518470970 | Freds of Doniphan Inc | Pharmacy | 100 H&s Drive, Doniphan, MO 63935 | 2017-11-08 |
| 1053706390 | Amazing In Home Services, LLC | In Home Supportive Care | 106 Lafayette Street, Doniphan, MO 63935 | 2015-04-03 |
| 1447649595 | Keshia J Russell | Speech-Language Pathologist | 1002 Elm Street, Doniphan, MO 63935 | 2015-01-13 |
| 1720327596 | Jessica L Eddington | Physical Therapist | 1015 Grand Street, Doniphan, MO 63935 | 2013-02-13 |
| 1700150927 | Ripley County Family Resource Center | Community/Behavioral Health | 204 Summit St., Doniphan, MO 63935 | 2012-03-06 |
| 1205107810 | Ripley County Family Resource Center | Community/Behavioral Health | 204 Summit, Doniphan, MO 63935 | 2012-01-13 |
| 1386825248 | Shopko Stores Operating Co LLC | Pharmacy | 111 Leroux Dr, Doniphan, MO 63935 | 2007-11-20 |
| 1104010081 | American Consumer Directed Services, L.L.C. | Clinic/Center | Rr 3, Box 2199, Doniphan, MO 63935 | 2007-09-04 |
| Find all providers in zip 63935 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518470970 | Freds of Doniphan Inc | Pharmacy | 100 H&s Drive, Doniphan, MO 63935 | 2017-11-08 |
| 1770932436 | Doniphan Pharmacy LLC | Pharmacy | 2011 West Clarice, Doniphan, NE 68832 | 2016-06-03 |
| 1407044621 | Shopko Stores Operating Co LLC | Pharmacy | 115 Leroux St, Doniphan, MO 63935-1038 | 2007-10-12 |
| 1811284060 | Premiere Healthcare LLC | Pharmacy | 513b N Grand Ave, Doniphan, MO 63935-1405 | 2011-07-07 |
| 1619082658 | E & S Pharmacy Inc | Pharmacy | 1105 Walnut St, Doniphan, MO 63935-1339 | 2006-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
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| 1750994869 | Script Partner Pharmacy LLC | Pharmacy | 100 Chesterfield Bus Pkwy Ste 279, Chesterfield, MO 63005-1271 | 2020-08-28 |
| 1821600545 | Debbie S Pharmacy LLC | Pharmacy | 815 Hazelwest Dr Ste 100, Hazelwood, MO 63042-1762 | 2020-08-24 |
| 1689285082 | Logan & Seiler Inc | Pharmacy | 102 Hospitality Drive, Suite B, Sikeston, MO 63801 | 2020-08-11 |
| 1023626389 | Lemonaid Community Pharmacy, Inc | Pharmacy | 7580 Watson Rd, Saint Louis, MO 63119-4409 | 2020-07-22 |
| 1689207870 | Washington University Cancer Center Pharmacy - North County | Pharmacy | 1225 Graham Rd Fl 1, Florissant, MO 63031-8012 | 2020-02-17 |
| 1942847413 | Southeast Hospital | Pharmacy | 2600 E. Main Street, Suite 113, Jackson, MO 63755 | 2019-12-04 |
| 1720624323 | Toney Drug & Wellness, LLC | Pharmacy | #1 Hals Plaza Dr, Piedmont, MO 63957 | 2019-11-19 |
| 1427606912 | Medley Pharmacy Inc | Pharmacy | 1024 S Bishop Ave, Rolla, MO 65401-4416 | 2019-08-28 |
| 1013479716 | Cerner Health Connections, Inc. | Pharmacy | 1403 Hampton Avenue, St. Louis, MO 63139 | 2019-04-02 |
| 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.