Provider Demographics
NPI:1245798933
Name:PREMIER CARE MEDICAL SERVICES PLLC
Entity Type:Organization
Organization Name:PREMIER CARE MEDICAL SERVICES PLLC
Other - Org Name:ALEXANDER DUPUIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:DUPUIS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:480-877-0120
Mailing Address - Street 1:212 W SUPERSTITION BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85120-4127
Mailing Address - Country:US
Mailing Address - Phone:480-877-0120
Mailing Address - Fax:888-498-4092
Practice Address - Street 1:212 W SUPERSTITION BLVD STE 101
Practice Address - Street 2:
Practice Address - City:APACHE JUNCTION
Practice Address - State:AZ
Practice Address - Zip Code:85120-4127
Practice Address - Country:US
Practice Address - Phone:480-877-0120
Practice Address - Fax:888-498-4092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-12
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care