Provider Demographics
NPI:1316638398
Name:PREMIUMRX SOLUTIONS LLC
Entity type:Organization
Organization Name:PREMIUMRX SOLUTIONS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:SHIV
Authorized Official - Middle Name:A
Authorized Official - Last Name:AGHARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-651-2374
Mailing Address - Street 1:26830 CYPRESSWOOD DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-9002
Mailing Address - Country:US
Mailing Address - Phone:480-882-8257
Mailing Address - Fax:
Practice Address - Street 1:26830 CYPRESSWOOD DR STE 101
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-9002
Practice Address - Country:US
Practice Address - Phone:281-651-2374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-18
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy