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Organization
PREMIER KIDS CARE, INC.
Active
Organization
PREMIER KIDS CARE, INC.
Active
Other names
Premier Care
Organization subpart
No
Provider details
NPI number
Authorized official
CHELLA LEICHT (CONTRACTS AND LICENSURE COORDINATOR)
(770) 207-9001
Entity
Organization
Contact information
Practice address
221 PLAZA DR, MONROE, GA 30655-3184
(770) 207-9001
(770) 207-8987
Mailing address
221 PLAZA DR, MONROE, GA 30655-3184
(770) 207-9001
(770) 207-8987
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PHRE008225
GA
3336C0003X
Community/Retail Pharmacy
Primary
PHRE008225
GA
3336S0011X
Specialty Pharmacy
PHRE008225
GA
Other
Enumeration date
03/08/2006
Last updated
01/02/2012
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