Provider Demographics
NPI:1851672687
Name:PREMIER MEDICAL CENTER OF INVERRARY, INC.
Entity Type:Organization
Organization Name:PREMIER MEDICAL CENTER OF INVERRARY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LAMKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-903-8142
Mailing Address - Street 1:9470 SW 49TH PL
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33328-3407
Mailing Address - Country:US
Mailing Address - Phone:954-903-8142
Mailing Address - Fax:
Practice Address - Street 1:4522 INVERRARY BLVD
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-4104
Practice Address - Country:US
Practice Address - Phone:800-406-7624
Practice Address - Fax:866-750-8103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-07
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty