Provider Demographics
| NPI: | 1982835005 |
|---|---|
| Name: | PREMIER PARTNERS, INC. |
| Entity type: | Organization |
| Organization Name: | PREMIER PARTNERS, INC. |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | PRESIDENT |
| Authorized Official - Prefix: | MR |
| Authorized Official - First Name: | DAVID |
| Authorized Official - Middle Name: | W |
| Authorized Official - Last Name: | MATHEWS |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 804-271-6750 |
| Mailing Address - Street 1: | 4718 BELFIELD CT |
| Mailing Address - Street 2: | |
| Mailing Address - City: | RICHMOND |
| Mailing Address - State: | VA |
| Mailing Address - Zip Code: | 23237-2127 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 804-271-6750 |
| Mailing Address - Fax: | 804-271-6751 |
| Practice Address - Street 1: | 4718 BELFIELD CT |
| Practice Address - Street 2: | |
| Practice Address - City: | RICHMOND |
| Practice Address - State: | VA |
| Practice Address - Zip Code: | 23237-2127 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 804-271-6750 |
| Practice Address - Fax: | 804-271-6751 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2009-08-06 |
| Last Update Date: | 2009-08-06 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| VA | 2705 047042A | 332BC3200X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 332BC3200X | Suppliers | Durable Medical Equipment & Medical Supplies | Customized Equipment |