Healthcare Provider Details

I. General information

NPI: 1295669463
Provider Name (Legal Business Name): PREMIERCARE BILLING & STAFFING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 RED ROSES AVE
DURHAM NC
27703-7235
US

IV. Provider business mailing address

1600 RED ROSES AVE
DURHAM NC
27703-7235
US

V. Phone/Fax

Practice location:
  • Phone: 919-891-0002
  • Fax:
Mailing address:
  • Phone: 919-891-0002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHAMELAH R WILLIAMS-LUSTER
Title or Position: MANAGING MEMBER
Credential:
Phone: 919-891-0002