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General NPI Number Information
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NPI Number | 1285942086
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Entity Type | Organization
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Legal Business Name | PREMIER HEARING AND HEALTH SERVICES INC
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Dates
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Enumeration Date | 09/15/2010
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Last Update Date | 01/27/2012
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Provider Practice Location Address
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Address Line | 300 W I PARKWAY STE 207 PREMIER HEARING AND HEALTH SERVICES INC
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City | DALLAS
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State | GA
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Zip | 30132
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Country | US
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Telephone | 770-621-5010
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Fax | 770-621-5010
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Provider Business Mailing Address
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Address Line | 300 WI PARKWAY SUITE 207 PREMIER HEARING AND HEALTH SERVICES INC
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City | DALLAS
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State | GA
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Zip | 30132-5079
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Country | US
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Telephone | 770-621-5010
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. XAVIER C MOORE
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Credential | M.D.
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Telephone | 404-396-5560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 1012
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License Number State | GA
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