Provider Demographics
NPI:1245614049
Name:PREMIER FAMILY CARE ARAB LLC
Entity Type:Organization
Organization Name:PREMIER FAMILY CARE ARAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JESS
Authorized Official - Middle Name:H
Authorized Official - Last Name:YOUNGBLOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-586-2324
Mailing Address - Street 1:20 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ARAB
Mailing Address - State:AL
Mailing Address - Zip Code:35016-1378
Mailing Address - Country:US
Mailing Address - Phone:256-586-2324
Mailing Address - Fax:
Practice Address - Street 1:20 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ARAB
Practice Address - State:AL
Practice Address - Zip Code:35016-1378
Practice Address - Country:US
Practice Address - Phone:256-586-2324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-13
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty