Healthcare Provider Details

I. General information

NPI: 1841507241
Provider Name (Legal Business Name): PREMIER HEALTH SPECIALISTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2010
Last Update Date: 11/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 E APPLE ST STE 1480
DAYTON OH
45409-2939
US

IV. Provider business mailing address

30 E APPLE ST STE 1480
DAYTON OH
45409-2939
US

V. Phone/Fax

Practice location:
  • Phone: 937-208-3220
  • Fax: 937-208-3633
Mailing address:
  • Phone: 937-208-3220
  • Fax: 937-208-3633

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: PRESIDENT/CEO
Credential:
Phone: 937-499-8866