Organization
PREMIER MEDICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. J. DOUGLAS CRAFT (PRESIDENT/CEO)
(404) 767-6400
Entity
Organization
Contact information
Practice address
327 DAHLONEGA ST STE A603, CUMMING, GA 30040-2488
(770) 781-4138
(770) 781-2588
Mailing address
327 DAHLONEGA ST STE A603, CUMMING, GA 30040-2488
(770) 781-4138
(770) 781-2588
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
356770
WELLCARE
GA
05
—
459823570A
—
GA
05
—
519893850A
—
GA
01
—
52614526
BLUE CROSS BLUE SHIELD
GA
01
—
5931689
AETNA
GA
01
—
6690445
CIGNA
GA
01
—
82480
NORTHWOODS
GA
Enumeration date
03/02/2006
Last updated
04/10/2019
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