Organization
PREMIER FAMILY HEALTH CARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STACIE MEDLIN SHEARIN MSW (PRESIDENT/OWNER)
(252) 519-2273
Entity
Organization
Contact information
Practice address
1704 HWY 158, ROANOKE RAPIDS, NC 27870-8378
(252) 519-2273
(252) 535-2399
Mailing address
1704 HWY 158, ROANOKE RAPIDS, NC 27870-8378
(252) 519-2273
(252) 535-2399
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
MHL-042-052
NC
251B00000X
Case Management Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019YW
BCBS
NC
05
—
3409692
—
NC
05
—
8300375
—
NC
01
—
8388
LME PROVIDER NUMBER
NC
Enumeration date
07/25/2006
Last updated
05/26/2009
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