Provider Demographics
NPI:1932120979
Name:PREMIER HEALTH ASSOCIATES INC
Entity Type:Organization
Organization Name:PREMIER HEALTH ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:REGGI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-823-4000
Mailing Address - Street 1:625 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:MINERVA
Mailing Address - State:OH
Mailing Address - Zip Code:44657-1027
Mailing Address - Country:US
Mailing Address - Phone:330-868-4187
Mailing Address - Fax:330-868-0134
Practice Address - Street 1:625 N MARKET ST
Practice Address - Street 2:
Practice Address - City:MINERVA
Practice Address - State:OH
Practice Address - Zip Code:44657-1027
Practice Address - Country:US
Practice Address - Phone:330-868-4187
Practice Address - Fax:330-868-0134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2286057Medicaid
OHPR9319092Medicare ID - Type Unspecified