Provider Demographics
NPI:1912254848
Name:PREMIER MEDICAL, INC.
Entity Type:Organization
Organization Name:PREMIER MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:VOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-710-1135
Mailing Address - Street 1:1202 E MARYLAND AVE
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-1342
Mailing Address - Country:US
Mailing Address - Phone:602-710-1135
Mailing Address - Fax:480-287-9563
Practice Address - Street 1:1202 E MARYLAND AVE
Practice Address - Street 2:SUITE 1A
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-1342
Practice Address - Country:US
Practice Address - Phone:602-710-1135
Practice Address - Fax:480-287-9563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty