Provider Demographics
NPI:1225354368
Name:PREMIER FAMILY PRACTICE LLC
Entity Type:Organization
Organization Name:PREMIER FAMILY PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-226-6220
Mailing Address - Street 1:43 W RIDGE PIKE
Mailing Address - Street 2:
Mailing Address - City:LIMERICK
Mailing Address - State:PA
Mailing Address - Zip Code:19468-1711
Mailing Address - Country:US
Mailing Address - Phone:610-226-6220
Mailing Address - Fax:610-226-6201
Practice Address - Street 1:1601 N KINGS HWY
Practice Address - Street 2:SUITE 800
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2309
Practice Address - Country:US
Practice Address - Phone:856-433-6220
Practice Address - Fax:856-433-6201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-14
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty