Provider Demographics
NPI:1508445941
Name:PREMIER INTEGRATED HEALTHCARE PLLC
Entity Type:Organization
Organization Name:PREMIER INTEGRATED HEALTHCARE PLLC
Other - Org Name:SOZO MEDICAL GROUP
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHIDOZIE
Authorized Official - Middle Name:C
Authorized Official - Last Name:EZE
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:480-231-4113
Mailing Address - Street 1:85 W COMBS RD STE 101-269
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-9125
Mailing Address - Country:US
Mailing Address - Phone:480-231-4113
Mailing Address - Fax:
Practice Address - Street 1:85 W COMBS RD STE 101-269
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85140-9125
Practice Address - Country:US
Practice Address - Phone:480-231-4113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-05
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty