Organization
PREMIER INTEGRATED MEDICAL ASSOCIATES, 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
540 LINCOLN PARK BLVD, SUITE 200, KETTERING, OH 45429-6401
(937) 298-8058
(937) 298-5638
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
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3005198
—
OH
Enumeration date
04/28/2006
Last updated
04/26/2019
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