PREMIUM CARE HEALTH LLC NPI 1588155055

NPI Information

NPI: 1588155055
Provider Name: PREMIUM CARE HEALTH, LLC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

Address:
1684 THORN RIDGE TRL
HAMPTON, GA
ZIP 30228
Phone: (614) 599-3617
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PREMIUM CARE HEALTH, LLC is a psychiatric/mental health nurse practitioner in Hampton, GA. PREMIUM CARE HEALTH, LLC NPI is 1588155055. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1684 THORN RIDGE TRL
HAMPTON, GA
ZIP 30228-129
Phone: (614) 599-3617
Fax: (877) 779-5837

The provider's authorized official is Olusola Olawale .
The authorized official title is Authorized Official and has the following contact phone number (614) 599-3617.

The enumeration date for this NPI number is 5/21/2018 and was last updated on 4/3/2020.

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	363LF0000X	Nurse Practitioner	Family			No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			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: 5/5/2024

NPI Synchronization or Removal

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