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NPI Code Detail

MEDICARE: PREMIER CARE OF OHIO LLC

MEDICARE: PREMIER CARE OF OHIO LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
3261QM2800XMethadone Clinic
4261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center
5251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1316503584
Entity Type Code : Organization
Provider Name (Legal Business Name) : PREMIER CARE OF OHIO LLC
Provider Business Mailing Address
First Line : 8444 N 90TH ST STE 100
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85258-4437
Country : US
Telephone Number : 602-248-8886
Fax Number : 602-248-8999
Provider Business Practice Location Address
First Line : 2727 SAINT JOHNS RD STE D
Second Line :
City : LIMA
State : OH
Zip : 45804-4029
Country : US
Telephone Number : 567-940-9145
Fax Number :
Authorized Official
Title or Position : VP OF REVENUE CYCLE
Name : CINDY GAITHER
Credential :
Telephone Number : 602-248-8886
Provider Enumeration Date : 05/14/2019
Last Update Date : 02/09/2024

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Directions to “PREMIER CARE OF OHIO LLC ” Practice Location

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