SJM PREMIER MEDICAL GROUP LLC NPI 1518607738

NPI Information

NPI: 1518607738
Provider Name: SJM PREMIER MEDICAL GROUP, LLC

Doing Business As: PREMIER MEDICAL GROUP

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
3131 N COUNTRY CLUB RD STE 107-108
TUCSON, AZ
ZIP 85716
Phone: (520) 372-8626
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SJM PREMIER MEDICAL GROUP, LLC is a primary care clinic center in Tucson, AZ. SJM PREMIER MEDICAL GROUP, LLC NPI is 1518607738. The provider is registered as an organization entity type.
The provider Is Doing Business As Premier Medical Group.

The provider's business location address is:

3131 N COUNTRY CLUB RD STE 107-108
TUCSON, AZ
ZIP 85716-649
Phone: (520) 372-8626
Fax: (520) 372-8456

The provider's authorized official is Nora Uehara .
The authorized official title is Executive Leadership and has the following contact phone number (808) 234-1094.

The enumeration date for this NPI number is 3/29/2022 and was last updated on 5/2/2022.

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	261QP2300X	Clinic/Center	Primary Care			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	=========	MEDICAID	HAWAII

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: 4/28/2024

NPI Synchronization or Removal

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