# PREMIUM CARE MEDICAL CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477995231
- **Authorized official:** PRINCESS DENNAR MD (CEO/MANAGING PARTNER)
- **Authorized official phone:** (504) 361-4203

## Contact information

- **Practice address:** 3570 HOLIDAY DR, SUITES 3-7, NEW ORLEANS, LA 70114-8287
- **Practice address phone:** (504) 361-4203
- **Practice address fax:** (504) 361-4204
- **Mailing address:** 3570 HOLIDAY DR, SUITES 3-7, NEW ORLEANS, LA 70114-8287
- **Mailing address phone:** (504) 361-4203
- **Mailing address fax:** (504) 361-4204

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |

## Other

- **Enumeration date:** 07/22/2013
- **Last updated:** 10/02/2013