Organization Name: | PREMIER HEALTHCARE OF PLACERVILLE |
NPI Number: | 1932345410 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN MOONEY (OWNER) |
Mailing Address: | 1980 Broadway Placerville |
State: | CA US |
Postal Code: | 956679001 |
Phone Number: | 5306223536 |
Fax Number: | 5306223538 |
NPI Enumeration Date: | 01/05/2009 |
NPI Last Update Date: | 04/28/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | A55172 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |