Healthcare Provider Details

I. General information

NPI: 1861679672
Provider Name (Legal Business Name): PREMIER FIRST ASSIST, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2008
Last Update Date: 11/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3110 N LLOYD BUSH DR
TUCSON AZ
85745
US

IV. Provider business mailing address

PO BOX 85520 PREMIER FIRST ASSIST
TUCSON AZ
85754-5520
US

V. Phone/Fax

Practice location:
  • Phone: 520-777-4470
  • Fax: 520-777-4470
Mailing address:
  • Phone: 520-777-4470
  • Fax: 520-777-4470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN048143
License Number StateAZ

VIII. Authorized Official

Name: MRS. JANET R HASKELL
Title or Position: OWNER
Credential: NPC CRNFA
Phone: 520-777-4470