Provider Demographics
NPI:1740528843
Name:PREMIER HEALTH SPECIALISTS INC
Entity type:Organization
Organization Name:PREMIER HEALTH SPECIALISTS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:DANIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD MBA
Authorized Official - Phone:937-499-9015
Mailing Address - Street 1:2 PRESTIGE PL
Mailing Address - Street 2:STE 210
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-3770
Mailing Address - Country:US
Mailing Address - Phone:937-435-6585
Mailing Address - Fax:937-435-6563
Practice Address - Street 1:2 PRESTIGE PL
Practice Address - Street 2:STE 210
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-3770
Practice Address - Country:US
Practice Address - Phone:937-435-6585
Practice Address - Fax:937-435-6563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-24
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0081671Medicaid
OH9353865Medicare PIN