Healthcare Provider Details

I. General information

NPI: 1952725087
Provider Name (Legal Business Name): PREMIER MEDICAL CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2014
Last Update Date: 02/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ALPHA AVE SUITE 20
VOORHEES NJ
08043-1049
US

IV. Provider business mailing address

1 ALPHA AVE SUITE 20
VOORHEES NJ
08043-1049
US

V. Phone/Fax

Practice location:
  • Phone: 856-616-2393
  • Fax: 856-427-6151
Mailing address:
  • Phone: 856-616-2393
  • Fax: 856-427-6151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: NANCY LUKE
Title or Position: CFO
Credential:
Phone: 866-616-2393