Provider Demographics
NPI:1689629065
Name:PREMIER HEALHT ASSOCIATES INC
Entity Type:Organization
Organization Name:PREMIER HEALHT ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING/REIMBURSEMENT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-829-9389
Mailing Address - Street 1:270 E STATE ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-4957
Mailing Address - Country:US
Mailing Address - Phone:330-823-4000
Mailing Address - Fax:330-829-2919
Practice Address - Street 1:270 E STATE ST
Practice Address - Street 2:SUITE 250
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-4957
Practice Address - Country:US
Practice Address - Phone:330-823-4000
Practice Address - Fax:330-829-2919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH228607Medicaid
OH228607Medicaid