Provider Demographics
NPI:1669668091
Name:PREMIER HEALTH SPECIALISTS INC
Entity Type:Organization
Organization Name:PREMIER HEALTH SPECIALISTS INC
Other - Org Name:ANNE CAMM PSYD COMPANY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-499-8866
Mailing Address - Street 1:1 MEDICAL CENTER DRIVE
Mailing Address - Street 2:FIFTH FLOOR
Mailing Address - City:FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-1066
Mailing Address - Country:US
Mailing Address - Phone:513-420-5233
Mailing Address - Fax:513-420-8768
Practice Address - Street 1:1 MEDICAL CENTER DRIVE
Practice Address - Street 2:FIFTH FLOOR
Practice Address - City:FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:45005-1066
Practice Address - Country:US
Practice Address - Phone:513-420-5233
Practice Address - Fax:513-420-8768
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PREMIER HEALTH SPECIALISTS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-19
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2211510Medicaid
OH9353865Medicare PIN