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NPI Code Detail

MEDICARE: PERMIAN PREMIER HEALTH SERVICES INC

MEDICARE: PERMIAN PREMIER HEALTH SERVICES INC
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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1558839076
Entity Type Code : Organization
Provider Name (Legal Business Name) : PERMIAN PREMIER HEALTH SERVICES INC
Provider Business Mailing Address
First Line : PO BOX 24573
Second Line :
City : BELFAST
State : ME
Zip : 04915-4496
Country : US
Telephone Number : 615-467-4158
Fax Number :
Provider Business Practice Location Address
First Line : 2929 CALDER ST STE 100
Second Line :
City : BEAUMONT
State : TX
Zip : 77702-1841
Country : US
Telephone Number : 615-467-4474
Fax Number : 615-467-1267
Authorized Official
Title or Position : PRESIDENT
Name : AMY GUAY
Credential :
Telephone Number : 617-789-5018
Provider Enumeration Date : 11/02/2018
Last Update Date : 08/22/2021

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Directions to “PERMIAN PREMIER HEALTH SERVICES INC ” Practice Location

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