Healthcare Provider Details

I. General information

NPI: 1811808736
Provider Name (Legal Business Name): PREMIER MOUNTAIN HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2931 ARIZONA HIGHWAY 260
OVERGAARD AZ
85933-9722
US

IV. Provider business mailing address

2931 ARIZONA HIGHWAY 260
OVERGAARD AZ
85933-9722
US

V. Phone/Fax

Practice location:
  • Phone: 928-251-4244
  • Fax: 833-539-1739
Mailing address:
  • Phone: 928-251-4244
  • Fax: 833-539-1739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH WILD BIERER
Title or Position: OWNER
Credential:
Phone: 928-537-4379