Provider Demographics
NPI:1174973648
Name:PREMIER PHARMACY NETWORK II
Entity type:Organization
Organization Name:PREMIER PHARMACY NETWORK II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:R
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD,MBA
Authorized Official - Phone:267-979-3948
Mailing Address - Street 1:PO BOX 428
Mailing Address - Street 2:
Mailing Address - City:MARCUS HOOK
Mailing Address - State:PA
Mailing Address - Zip Code:19061-0428
Mailing Address - Country:US
Mailing Address - Phone:610-485-7750
Mailing Address - Fax:
Practice Address - Street 1:2530 W CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008-2429
Practice Address - Country:US
Practice Address - Phone:610-356-6491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-15
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies