Provider Demographics
NPI:1962827907
Name:PREMIER SCREENING LLC
Entity Type:Organization
Organization Name:PREMIER SCREENING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:MULLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-236-3694
Mailing Address - Street 1:155 N LAKE AVE
Mailing Address - Street 2:SUITE 800
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1849
Mailing Address - Country:US
Mailing Address - Phone:626-236-3694
Mailing Address - Fax:
Practice Address - Street 1:155 N LAKE AVE
Practice Address - Street 2:SUITE 800
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-1849
Practice Address - Country:US
Practice Address - Phone:626-236-3694
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-27
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory