Provider Demographics
NPI:1548806003
Name:PREMIER DIAGNOSTICS OF VIRGINIA INC
Entity Type:Organization
Organization Name:PREMIER DIAGNOSTICS OF VIRGINIA INC
Other - Org Name:PREMIER CPAP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARVET
Authorized Official - Middle Name:L
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-586-5185
Mailing Address - Street 1:704 THIMBLE SHOALS BLVD STE 500C
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4561
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:704 THIMBLE SHOALS BLVD STE 500C
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4561
Practice Address - Country:US
Practice Address - Phone:804-378-3713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PREMIER DIAGNOSTICS OF VIRGINIA INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-11-20
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies