MEDICARE: PREMIER PHYSICIANS CENTERS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1578987376
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIER PHYSICIANS CENTERS, INC.

Provider Business Mailing Address
First Line	:	24651 CENTER RIDGE RD
Second Line	:	SUITE 350
City	:	WESTLAKE
State	:	OH
Zip	:	44145-5635
Country	:	US
Telephone Number	:	440-895-5056
Fax Number	:	440-333-2935

Provider Business Practice Location Address
First Line	:	2709 FRANKLIN BLVD
Second Line	:	SUITE 2E
City	:	CLEVELAND
State	:	OH
Zip	:	44113-2993
Country	:	US
Telephone Number	:	216-227-2194
Fax Number	:	216-227-2196

Authorized Official
Title or Position	:	CEO
Name	:	DAVID B APPEL
Credential	:
Telephone Number	:	440-333-0889

Provider Enumeration Date	:	02/13/2014
Last Update Date	:	02/13/2014

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