Provider Demographics
NPI:1356681993
Name:PREMIER HEALTH SPECIALISTS INC
Entity Type:Organization
Organization Name:PREMIER HEALTH SPECIALISTS INC
Other - Org Name:PREMIER FOOT SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD MBA
Authorized Official - Phone:937-499-9015
Mailing Address - Street 1:9000 N MAIN ST
Mailing Address - Street 2:STE 201
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-1180
Mailing Address - Country:US
Mailing Address - Phone:937-435-6585
Mailing Address - Fax:937-435-6563
Practice Address - Street 1:136 S LUDLOW ST
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-1813
Practice Address - Country:US
Practice Address - Phone:937-499-8273
Practice Address - Fax:937-223-9811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-19
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty