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
2322 LAKEVIEW DR, BEAVERCREEK, OH 45431
(937) 320-3848
(937) 320-3848
Mailing address
25 MERCHANT ST, STE 220 - ATTN CREDENTIALING, CINCINNATI, OH 45246-3740
(513) 533-1199
(513) 645-9827
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2106232
—
OH
01
—
CA2478
MEDICARE RR ID
OH
Enumeration date
04/28/2006
Last updated
07/15/2019
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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