Provider Demographics
NPI:1861679672
Name:PREMIER FIRST ASSIST, LLC
Entity Type:Organization
Organization Name:PREMIER FIRST ASSIST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:R
Authorized Official - Last Name:HASKELL
Authorized Official - Suffix:
Authorized Official - Credentials:NPC CRNFA
Authorized Official - Phone:520-777-4470
Mailing Address - Street 1:PO BOX 85520
Mailing Address - Street 2:PREMIER FIRST ASSIST
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85754-5520
Mailing Address - Country:US
Mailing Address - Phone:520-777-4470
Mailing Address - Fax:520-777-4470
Practice Address - Street 1:3110 N LLOYD BUSH DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745
Practice Address - Country:US
Practice Address - Phone:520-777-4470
Practice Address - Fax:520-777-4470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN048143163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-SurgicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ184987Medicaid
107531Medicare PIN
596644Medicare UPIN