Provider Demographics
NPI:1356188627
Name:PREMIER HEALTH & WELLNESS,LL
Entity type:Organization
Organization Name:PREMIER HEALTH & WELLNESS,LL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:THORNLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-606-3415
Mailing Address - Street 1:1300 HOSPITAL DR STE 370
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3245
Mailing Address - Country:US
Mailing Address - Phone:256-606-3415
Mailing Address - Fax:
Practice Address - Street 1:1300 HOSPITAL DR STE 370
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3245
Practice Address - Country:US
Practice Address - Phone:256-606-3415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate HealthGroup - Multi-Specialty