Provider Demographics
NPI:1154472934
Name:PREMIER HEALTH SPECIALISTS INC
Entity Type:Organization
Organization Name:PREMIER HEALTH SPECIALISTS INC
Other - Org Name:WOMENS HEALTH SPECIALISTS AND MIDWIVES OF DAYTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-499-9015
Mailing Address - Street 1:900 S DIXIE DR
Mailing Address - Street 2:SUITE 40
Mailing Address - City:VANDALIA
Mailing Address - State:OH
Mailing Address - Zip Code:45377-2657
Mailing Address - Country:US
Mailing Address - Phone:937-890-6644
Mailing Address - Fax:937-890-1726
Practice Address - Street 1:900 S DIXIE DR
Practice Address - Street 2:SUITE 40
Practice Address - City:VANDALIA
Practice Address - State:OH
Practice Address - Zip Code:45377-2657
Practice Address - Country:US
Practice Address - Phone:937-890-6644
Practice Address - Fax:937-890-1726
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PREMIER HEALTH SPECIALISTS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-16
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Multi-Specialty
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2724369Medicaid
OH9353865Medicare PIN