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General NPI Number Information
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NPI Number | 1619209475
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Entity Type | Organization
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Legal Business Name | PREMIER HEALTH CARE LLC
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Dates
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Enumeration Date | 02/04/2010
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Last Update Date | 02/17/2016
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Provider Practice Location Address
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Address Line | 2845 PROGRESS WAY
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City | WILMINGTON
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State | OH
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Zip | 45177
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Country | US
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Telephone | 937-366-1082
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Fax | 937-366-1083
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Provider Business Mailing Address
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Address Line | P.O. BOX 644671
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City | PITTSBURGH
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State | OH
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Zip | 15264-4671
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Country | US
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Telephone | 937-366-1082
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | SON M BACH
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Credential | MD
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Telephone | 937-366-1082
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 35-088053
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License Number State | OH
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