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General NPI Number Information
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NPI Number | 1730625708
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Entity Type | Organization
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Legal Business Name | PREMED MEDICAL SERVICES, INC.
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Dates
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Enumeration Date | 01/13/2017
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Last Update Date | 01/13/2017
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Provider Practice Location Address
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Address Line | 8956 CRESTVIEW CIR
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City | UNION CITY
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State | GA
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Zip | 30291-6071
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Country | US
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Telephone | 770-883-1434
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Fax |
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Provider Business Mailing Address
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Address Line | 8956 CRESTVIEW CIR
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City | UNION CITY
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State | GA
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Zip | 30291-6071
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Country | US
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Telephone | 770-883-1434
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | SHEILA TILLMAN
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Credential |
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Telephone | 770-883-1434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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