Provider Demographics
NPI:1891932604
Name:PREMIER HEALTH SPECIALISTS INC
Entity Type:Organization
Organization Name:PREMIER HEALTH SPECIALISTS INC
Other - Org Name:PEDIATRIC CARDIOLOGY OF DAYTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-435-4263
Mailing Address - Street 1:5450 FAR HILLS AVE
Mailing Address - Street 2:SUITE 124
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-2386
Mailing Address - Country:US
Mailing Address - Phone:937-435-2920
Mailing Address - Fax:
Practice Address - Street 1:5450 FAR HILLS AVE
Practice Address - Street 2:SUITE 124
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-2386
Practice Address - Country:US
Practice Address - Phone:937-435-2920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PREMIER HEALTH SPECIALISTS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-01-15
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric CardiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2951186Medicaid
OH9353865Medicare PIN