Provider Demographics
NPI:1023556420
Name:PREMIER HEALTH SPECIALISTS INC
Entity Type:Organization
Organization Name:PREMIER HEALTH SPECIALISTS INC
Other - Org Name:PREMIER ORTHOPEDICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERRANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-991-3188
Mailing Address - Street 1:2350 MIAMI VALLEY DR STE 320A
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4778
Mailing Address - Country:US
Mailing Address - Phone:937-312-1661
Mailing Address - Fax:937-312-1701
Practice Address - Street 1:2350 MIAMI VALLEY DR STE 320A
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-4778
Practice Address - Country:US
Practice Address - Phone:937-312-1661
Practice Address - Fax:937-312-1701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-06
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies