Healthcare Provider Details

I. General information

NPI: 1033155601
Provider Name (Legal Business Name): PREMIER MEDICAL EQUIPMENT. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 11/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 CRYE LEIKE DR
FORT OGLETHORPE GA
30742-4055
US

IV. Provider business mailing address

89 CRYE LEIKE DR
FORT OGLETHORPE GA
30742-4055
US

V. Phone/Fax

Practice location:
  • Phone: 706-858-6771
  • Fax: 706-858-6772
Mailing address:
  • Phone: 706-858-6771
  • Fax: 706-858-6772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: LISA A SCOTT
Title or Position: PRESIDENT
Credential:
Phone: 423-648-4164