Provider Demographics
NPI:1386632651
Name:PREMIER CARE FOR WOMEN PC
Entity Type:Organization
Organization Name:PREMIER CARE FOR WOMEN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EVA
Authorized Official - Middle Name:S
Authorized Official - Last Name:ARKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-257-0170
Mailing Address - Street 1:960 JOHNSON FERRY RD NE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-4771
Mailing Address - Country:US
Mailing Address - Phone:404-257-0170
Mailing Address - Fax:404-851-9894
Practice Address - Street 1:960 JOHNSON FERRY RD NE
Practice Address - Street 2:SUITE 400
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-4771
Practice Address - Country:US
Practice Address - Phone:404-257-0170
Practice Address - Fax:404-851-9894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-11
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA=========OtherFED ID