Organization Name: | PREMIER HEALTHCARE |
NPI Number: | 1053798892 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AMY S COX (PRESIDENT) |
Mailing Address: | 425 College Dr S Ste #14 Devils Lake |
State: | ND US |
Postal Code: | 583013537 |
Phone Number: | 7016628662 |
Fax Number: | 7016628217 |
NPI Enumeration Date: | 04/30/2015 |
NPI Last Update Date: | 04/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ND |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |