Provider Demographics
NPI:1912194473
Name:PREMIER ADULT HEALTH CARE INC
Entity Type:Organization
Organization Name:PREMIER ADULT HEALTH CARE INC
Other - Org Name:PREMIER MEDICAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SIMRITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIDHU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-597-1011
Mailing Address - Street 1:4428 COMMERCIAL WAY
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-1966
Mailing Address - Country:US
Mailing Address - Phone:352-597-1011
Mailing Address - Fax:352-597-7803
Practice Address - Street 1:4428 COMMERCIAL WAY
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-1966
Practice Address - Country:US
Practice Address - Phone:352-597-1011
Practice Address - Fax:352-597-7803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0072341207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF97386Medicare UPIN
F51177Medicare UPIN