Organization
PREMIER HEALTH SYSTEMS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ETHEL EHRIANO AGBARHA MD (CEO)
(774) 633-4876
Entity
Organization
Contact information
Practice address
22 MAIN ST, AUBURN, MA 01501-1625
(774) 633-4876
Mailing address
22 MAIN ST, AUBURN, MA 01501-1625
(774) 633-4876
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
305S00000X
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110099034/A
MASS HEALTH
MA
Enumeration date
03/20/2015
Last updated
03/20/2015
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