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Organization
PREMIER INTEGRATED MEDICAL ASSOC LTD
Active
Organization
PREMIER INTEGRATED MEDICAL ASSOC LTD
Active
Other names
PriMed Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK A COUCH MD (PRESIDENT)
(937) 898-3600
Entity
Organization
Contact information
Practice address
1900 COMPOSITE DR, KETTERING, OH 45420-1475
(937) 293-8419
(937) 293-1545
Mailing address
1900 COMPOSITE DR, KETTERING, OH 45420-1475
(937) 293-8419
(937) 293-1545
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2112958
—
OH
01
—
=========
TRICARE GROUP NUMBER
—
01
—
CA2478
MEDICARE RR
OH
Enumeration date
04/25/2006
Last updated
12/10/2022
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