Healthcare Provider Details

I. General information

NPI: 1992774392
Provider Name (Legal Business Name): PREMIER HEALTH MANAGEMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 04/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1206 COLLEGE AVE
JACKSON AL
36545-2407
US

IV. Provider business mailing address

2880 DAUPHIN ST
MOBILE AL
36606-2457
US

V. Phone/Fax

Practice location:
  • Phone: 251-246-3231
  • Fax: 251-246-3034
Mailing address:
  • Phone: 251-473-1900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number244
License Number StateAL

VIII. Authorized Official

Name: JAMES L. SPIRES
Title or Position: CEO
Credential:
Phone: 251-341-3368