Healthcare Provider Details

I. General information

NPI: 1558314666
Provider Name (Legal Business Name): PREMIER HEALTH MANAGEMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 06/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 ALABAMA AVE W
THOMASVILLE AL
36784-3100
US

IV. Provider business mailing address

2880 DAUPHIN ST
MOBILE AL
36606-2457
US

V. Phone/Fax

Practice location:
  • Phone: 334-636-2529
  • Fax:
Mailing address:
  • Phone: 251-473-1900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: JAMES W. HARTMAN III
Title or Position: CEO
Credential:
Phone: 251-473-1900