Healthcare Provider Details

I. General information

NPI: 1750843496
Provider Name (Legal Business Name): PREMIER PEDIATRICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2019
Last Update Date: 04/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 GEORGIA AVE NW STE 323
WASHINGTON DC
20012-1616
US

IV. Provider business mailing address

7600 GEORGIA AVE NW STE 323
WASHINGTON DC
20012-1616
US

V. Phone/Fax

Practice location:
  • Phone: 202-723-3060
  • Fax: 202-723-3065
Mailing address:
  • Phone: 202-723-3060
  • Fax: 202-723-3065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. CHINENYE UCHECHUKWU ARUNGWA
Title or Position: DIRECTOR OF BUSINESS DEVELOPMENT
Credential:
Phone: 202-723-3060