Healthcare Provider Details

I. General information

NPI: 1285808543
Provider Name (Legal Business Name): PREMIER HEALTH SPECIALISTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2008
Last Update Date: 11/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 S MAIN ST SUITE 3
DAYTON OH
45409-2698
US

IV. Provider business mailing address

1520 S MAIN ST SUITE 3
DAYTON OH
45409-2698
US

V. Phone/Fax

Practice location:
  • Phone: 937-208-7240
  • Fax: 937-208-7242
Mailing address:
  • Phone: 937-208-7240
  • Fax: 937-208-7242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER DANIS
Title or Position: CEO/PRESIDENT
Credential:
Phone: 937-435-4263