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General NPI Number Information
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NPI Number | 1841669678
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Entity Type | Organization
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Legal Business Name | AT YOUR SERVICE PREMIER SERVICE LLC
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Dates
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Enumeration Date | 09/23/2015
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Last Update Date | 09/23/2015
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Provider Practice Location Address
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Address Line | 170 S LINCOLN ST SUITE 100
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City | SPOKANE
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State | WA
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Zip | 99201-4443
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Country | US
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Telephone | 425-256-1430
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Fax |
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Provider Business Mailing Address
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Address Line | 170 S LINCOLN ST SUITE 100
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City | SPOKANE
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State | WA
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Zip | 99201-4443
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIE JACKSON
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Credential |
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Telephone | 425-256-1430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 603359113
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License Number State | WA
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