Provider Demographics
NPI:1841669678
Name:AT YOUR SERVICE PREMIER SERVICE LLC
Entity type:Organization
Organization Name:AT YOUR SERVICE PREMIER SERVICE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-256-1430
Mailing Address - Street 1:170 S LINCOLN ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-4443
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:170 S LINCOLN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-4443
Practice Address - Country:US
Practice Address - Phone:425-256-1430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-23
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA603359113332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies