Provider Demographics
NPI:1780913780
Name:PREMIER OFFICE & MEDICAL SUPPLIERS
Entity type:Organization
Organization Name:PREMIER OFFICE & MEDICAL SUPPLIERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:1800-421-4261
Mailing Address - Street 1:1020 49TH ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-3929
Mailing Address - Country:US
Mailing Address - Phone:180-042-1426
Mailing Address - Fax:202-449-4672
Practice Address - Street 1:1020 49TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-3929
Practice Address - Country:US
Practice Address - Phone:180-042-1426
Practice Address - Fax:202-449-4672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-22
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies