Provider Demographics
NPI:1306419056
Name:PREMIER MEDICAL INTEGRATION LLC
Entity Type:Organization
Organization Name:PREMIER MEDICAL INTEGRATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MCFARLANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-369-4409
Mailing Address - Street 1:11030 N TATUM BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-6073
Mailing Address - Country:US
Mailing Address - Phone:602-369-4409
Mailing Address - Fax:
Practice Address - Street 1:11030 N TATUM BLVD STE 102
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-6073
Practice Address - Country:US
Practice Address - Phone:602-369-4409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty