Provider Demographics
NPI:1942830955
Name:PREMIER HEALTH, INC
Entity Type:Organization
Organization Name:PREMIER HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NARENDRA
Authorized Official - Middle Name:R
Authorized Official - Last Name:UPADHYAYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-986-1232
Mailing Address - Street 1:11067 GARDEN RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-7308
Mailing Address - Country:US
Mailing Address - Phone:954-986-1232
Mailing Address - Fax:954-986-1833
Practice Address - Street 1:11067 GARDEN RIDGE CT
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-7308
Practice Address - Country:US
Practice Address - Phone:954-986-1232
Practice Address - Fax:954-986-1833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-17
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty