Provider Demographics
NPI:1841589751
Name:PREMIER HEALTH CARE LLC
Entity Type:Organization
Organization Name:PREMIER HEALTH CARE LLC
Other - Org Name:PREMIER URGENT CARE OF WILMINGTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:MACHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GIORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-723-2111
Mailing Address - Street 1:2845 PROGRESS WAY
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:45177-7704
Mailing Address - Country:US
Mailing Address - Phone:937-366-1082
Mailing Address - Fax:937-366-1083
Practice Address - Street 1:2845 PROGRESS WAY
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:OH
Practice Address - Zip Code:45177-7704
Practice Address - Country:US
Practice Address - Phone:937-366-1082
Practice Address - Fax:937-366-1083
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PREMIER HEALTH CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-31
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care