Healthcare Provider Details

I. General information

NPI: 1154583284
Provider Name (Legal Business Name): PREMIER HEALTH SCREENING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2008
Last Update Date: 06/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2244 OLD WASHINGTON RD
CEDAR HILL TN
37032
US

IV. Provider business mailing address

PO BOX 198
CEDAR HILL TN
37032-0198
US

V. Phone/Fax

Practice location:
  • Phone: 615-945-0082
  • Fax:
Mailing address:
  • Phone: 615-945-0082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2471V0105X
TaxonomyVascular Sonography Radiologic Technologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID D WOODWARD
Title or Position: DIRECTOR OF OPERATIONS/ OWNER
Credential:
Phone: 615-948-0141