Provider Demographics
NPI:1871834739
Name:PREMIER MEDICINE PC
Entity Type:Organization
Organization Name:PREMIER MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:ATTANASIO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:215-336-2145
Mailing Address - Street 1:1701 W RITNER ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19145-4324
Mailing Address - Country:US
Mailing Address - Phone:215-336-2145
Mailing Address - Fax:215-336-5732
Practice Address - Street 1:1701 W RITNER ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145
Practice Address - Country:US
Practice Address - Phone:215-336-2145
Practice Address - Fax:215-336-5732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-01
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care