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General NPI Number Information
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NPI Number | 1922775865
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Entity Type | Organization
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Legal Business Name | PREMIER HEALTH LLC
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Dates
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Enumeration Date | 08/27/2021
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Last Update Date | 08/27/2021
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Provider Practice Location Address
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Address Line | 921 PRINCE ST
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City | GEORGETOWN
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State | SC
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Zip | 29440-3549
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Country | US
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Telephone | 256-499-2319
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2178
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City | MOUNT PLEASANT
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State | SC
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Zip | 29465-2178
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Country | US
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Telephone | 256-499-2319
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | ROBERT DOWNING
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Credential |
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Telephone | 256-499-2319
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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