Provider Demographics
NPI:1508445362
Name:PREMIER COMMUNITY HEALTHCARE GROUP, INC.
Entity Type:Organization
Organization Name:PREMIER COMMUNITY HEALTHCARE GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:RESNICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-518-2000
Mailing Address - Street 1:PO BOX 232
Mailing Address - Street 2:
Mailing Address - City:DADE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33526-0232
Mailing Address - Country:US
Mailing Address - Phone:352-518-2000
Mailing Address - Fax:352-567-0218
Practice Address - Street 1:6906 MADISON ST
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-1902
Practice Address - Country:US
Practice Address - Phone:352-518-2000
Practice Address - Fax:352-567-0218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty