PREMIER MOUNTAIN HEALTHCARE LLC NPI 1881261857

NPI Information

NPI: 1881261857
Provider Name: PREMIER MOUNTAIN HEALTHCARE LLC
Classification: Family Medicine - 207QA0505X
Entity Type: Organization

Specialization: Adult Medicine

CLIA Number: 03D0881531

Address:
5300 S SUTTER DR STE A
SHOW LOW, AZ
ZIP 85901
Phone: (928) 634-5118
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PREMIER MOUNTAIN HEALTHCARE LLC is an adult medicine family medicine in Show Low, AZ. The provider is definition to come. PREMIER MOUNTAIN HEALTHCARE LLC NPI is 1881261857. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

5300 S SUTTER DR STE A
SHOW LOW, AZ
ZIP 85901-054
Phone: (928) 634-5118

The provider's authorized official is Stella Crozier .
The authorized official title is Credentialing and has the following contact phone number (928) 634-5118.

The CLIA number assigned to this NPI record is 03D0881531 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/8/2021 and was last updated on 10/20/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207QA0505X	Family Medicine	Adult Medicine			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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