Provider Demographics
NPI:1750843496
Name:PREMIER PEDIATRICS LLC
Entity Type:Organization
Organization Name:PREMIER PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BUSINESS DEVELOPMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHINENYE
Authorized Official - Middle Name:UCHECHUKWU
Authorized Official - Last Name:ARUNGWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-723-3060
Mailing Address - Street 1:7600 GEORGIA AVE NW STE 323
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-1616
Mailing Address - Country:US
Mailing Address - Phone:202-723-3060
Mailing Address - Fax:202-723-3065
Practice Address - Street 1:7600 GEORGIA AVE NW STE 323
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-1616
Practice Address - Country:US
Practice Address - Phone:202-723-3060
Practice Address - Fax:202-723-3065
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE PREMIER HEALTH GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No251F00000XAgenciesHome Infusion