Provider Demographics
NPI:1013380344
Name:PREMIER CARE FOR WOMEN LLC
Entity Type:Organization
Organization Name:PREMIER CARE FOR WOMEN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:KNAPP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-392-6033
Mailing Address - Street 1:677 E PULASKI HWY
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-6037
Mailing Address - Country:US
Mailing Address - Phone:410-392-6033
Mailing Address - Fax:443-593-3994
Practice Address - Street 1:677 E PULASKI HWY
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-6037
Practice Address - Country:US
Practice Address - Phone:410-392-6033
Practice Address - Fax:443-593-3994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-09
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty