Organization
PREMIUM LIFE MEDICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND RAMIREZ MD (DOCTOR MANAGER)
(678) 395-3443
Entity
Organization
Contact information
Practice address
639 BEAVER RUIN RD NW STE A, LILBURN, GA 30047-3473
(678) 395-3443
(770) 837-2426
Mailing address
639 BEAVER RUIN RD NW STE A, LILBURN, GA 30047-3473
(678) 395-3443
(770) 837-2426
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
03/06/2023
Last updated
03/06/2023
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