Provider Demographics
NPI:1164951257
Name:PREMIER HEALTH LLC
Entity Type:Organization
Organization Name:PREMIER HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PALLAVI
Authorized Official - Middle Name:
Authorized Official - Last Name:GOWDA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:301-309-0940
Mailing Address - Street 1:15005 SHADY GROVE RD STE 220
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6358
Mailing Address - Country:US
Mailing Address - Phone:301-309-0940
Mailing Address - Fax:660-951-7834
Practice Address - Street 1:15005 SHADY GROVE RD STE 220
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6358
Practice Address - Country:US
Practice Address - Phone:301-309-0940
Practice Address - Fax:660-951-7834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-12
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty