Healthcare Provider Details

I. General information

NPI: 1093074890
Provider Name (Legal Business Name): PREMIER HEALTH SPECIALISTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2012
Last Update Date: 12/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2350 MIAMI VALLEY DR STE 310
DAYTON OH
45459-4778
US

IV. Provider business mailing address

2350 MIAMI VALLEY DR STE 310
DAYTON OH
45459-4778
US

V. Phone/Fax

Practice location:
  • Phone: 937-435-4263
  • Fax: 937-298-9459
Mailing address:
  • Phone: 937-435-4263
  • Fax: 937-298-9459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER J DANIS
Title or Position: CEO/PRESIDENT
Credential: MD
Phone: 937-499-8866