Organization
PREMIUM SECURITY PORTAMEDIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICE NEALE (OWNER)
(229) 603-8563
Entity
Organization
Contact information
Practice address
3480 PRESTON RIDGE RD STE 578, ALPHARETTA, GA 30005-2028
(470) 628-1069
Mailing address
793 LOBDALE FALLS DR, LAWRENCEVILLE, GA 30045-2217
(229) 603-8563
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
06/19/2026
Last updated
06/19/2026
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