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PREMIUM PHARMACY LLC
NPI 1669884524
Pharmacy - Community/Retail Pharmacy in Dearborn, MI

Active since May 27, 2014
3808 MONROE ST, DEARBORN, MI 48124(313) 209-3339(313) 586-9522 Get Directions Write a Review

NPPES record last updated: November 7, 2014. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Premium Pharmacy Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PREMIUM PHARMACY LLC (NPI 1669884524) is a healthcare organization registered as a community/retail pharmacy in Dearborn, Michigan and active in the NPI registry since May 2014. The organization lists Wafaa Dakhlallah Hakim, Pharmacist, as its authorized official.

NPPES Registry Identity

NPI1669884524
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NamePREMIUM PHARMACY LLC
Location Address3808 MONROE STDearborn, MI 48124-3620
Mailing Address3808 Monroe StDearborn, MI 48124-3620 · (313) 768-8494 · Fax (313) 586-9522
Phone(313) 209-3339
Fax(313) 586-9522
Organization SubpartNo
Authorized OfficialWafaa Dakhlallah HakimPharmacist · (313) 209-3339
Enumeration DateMay 27, 2014
Last NPPES UpdateNovember 7, 2014
✔ NPI 1669884524 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
Definition
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.
3808 MONROE ST, Dearborn, MI 48124
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arkansas Health & Wellness and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Premium Pharmacy Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by March 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateMichiganEnrollment IDO20220302002029Non-DME Part B · Mass Immunization (Roster Biller Only)Due dateMarch 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WAFAA HAKIM
Pharmacist
3808 MONROE ST
DEARBORN, MI 48124
Wayne County (313) 209-3339

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Premium Pharmacy LLC's NPI number?

The NPI number for Premium Pharmacy LLC is 1669884524. It was assigned to this organization in the NPPES registry on May 27, 2014.

Where is Premium Pharmacy LLC located?

Premium Pharmacy LLC is located at 3808 Monroe St, Dearborn, MI 48124. The listed phone number is (313) 209-3339.

What is Premium Pharmacy LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Is Premium Pharmacy LLC enrolled in Medicare?

Yes. Premium Pharmacy LLC is registered in the Medicare PECOS enrollment system.

When is Premium Pharmacy LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Michigan, Mass Immunization (Roster Biller Only)) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

What insurance does Premium Pharmacy LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arkansas Health & Wellness and 46 other insurers list Premium Pharmacy LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Premium Pharmacy LLC was last updated on November 7, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.