Provider Demographics
NPI:1184194656
Name:PREMIER CHOICE LLC
Entity Type:Organization
Organization Name:PREMIER CHOICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROQUELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BINGAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:717-941-9033
Mailing Address - Street 1:470 N 48TH ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-3421
Mailing Address - Country:US
Mailing Address - Phone:717-941-9033
Mailing Address - Fax:717-340-0008
Practice Address - Street 1:470 N 48TH ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-3421
Practice Address - Country:US
Practice Address - Phone:717-941-9033
Practice Address - Fax:717-340-0008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-28
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty