Provider Demographics
NPI:1831445576
Name:PREMIER IMAGING, LLC
Entity type:Organization
Organization Name:PREMIER IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, HIGH POINT MEDICAL CENTE
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:HOEKSTRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-716-8021
Mailing Address - Street 1:4515 PREMIER DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-8357
Mailing Address - Country:US
Mailing Address - Phone:336-801-5876
Mailing Address - Fax:336-801-5855
Practice Address - Street 1:4515 PREMIER DR
Practice Address - Street 2:SUITE 101
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265
Practice Address - Country:US
Practice Address - Phone:336-801-5876
Practice Address - Fax:336-801-5855
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HIGH POINT REGIONAL HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-07-31
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5917041Medicaid
NC1841516960Medicare UPIN