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General NPI Number Information
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NPI Number | 1245798933
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Entity Type | Organization
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Legal Business Name | PREMIER CARE MEDICAL SERVICES PLLC
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Dates
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Enumeration Date | 03/12/2019
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Last Update Date | 11/25/2022
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Provider Practice Location Address
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Address Line | 212 W SUPERSTITION BLVD STE 101
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City | APACHE JUNCTION
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State | AZ
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Zip | 85120-4127
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Country | US
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Telephone | 480-877-0120
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Fax | 888-498-4092
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Provider Business Mailing Address
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Address Line | 212 W SUPERSTITION BLVD STE 101
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City | APACHE JUNCTION
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State | AZ
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Zip | 85120-4127
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Country | US
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Telephone | 480-877-0120
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Fax | 888-498-4092
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Authorized Official
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Title or Position | OWNER/ MANAGER
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Name | ALEXANDER DUPUIS
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Credential | FNP-C
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Telephone | 480-877-0120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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