Provider Demographics
NPI:1376272013
Name:PREMIUM HEALTHCARE ADVANCE INC.
Entity Type:Organization
Organization Name:PREMIUM HEALTHCARE ADVANCE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ANITRA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMERON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-252-6711
Mailing Address - Street 1:10675 SW 190TH ST STE 1201
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-7712
Mailing Address - Country:US
Mailing Address - Phone:888-252-6711
Mailing Address - Fax:786-460-8004
Practice Address - Street 1:10675 SW 190TH ST STE 1201
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-7712
Practice Address - Country:US
Practice Address - Phone:888-252-6711
Practice Address - Fax:786-460-8004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies