Provider Demographics
NPI:1033155601
Name:PREMIER MEDICAL EQUIPMENT. LLC
Entity Type:Organization
Organization Name:PREMIER MEDICAL EQUIPMENT. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-648-4164
Mailing Address - Street 1:89 CRYE LEIKE DR
Mailing Address - Street 2:
Mailing Address - City:FORT OGLETHORPE
Mailing Address - State:GA
Mailing Address - Zip Code:30742-4055
Mailing Address - Country:US
Mailing Address - Phone:706-858-6771
Mailing Address - Fax:706-858-6772
Practice Address - Street 1:89 CRYE LEIKE DR
Practice Address - Street 2:
Practice Address - City:FORT OGLETHORPE
Practice Address - State:GA
Practice Address - Zip Code:30742-4055
Practice Address - Country:US
Practice Address - Phone:706-858-6771
Practice Address - Fax:706-858-6772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA5480980003Medicare NSC