Organization
PREMIER PHYSICIANS CENTERS, INC
Active
Parent organization
PREMIER PHYSICIANS CENTERS, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
PREMIER PHYSICIANS CENTERS, INC.
Authorized official
MR. DICK FINTZ (CFO)
(440) 895-5056
Entity
Organization
Contact information
Practice address
25200 CENTER RIDGE RD, WESTLAKE, OH 44145-4141
(440) 895-5057
(440) 895-5050
Mailing address
24500 CENTER RIDGE RD STE 375, WESTLAKE, OH 44145-5631
(440) 895-5057
(440) 895-5050
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0119204
GROUP MEDICAID
—
01
—
1396928883
GROUP NPI
—
01
—
220004287
RAILROAD MEDICARE GROUP #
—
01
—
3610861
GROUP ASC
—
01
—
CA4511
GROUP RR MEDICARE
—
01
—
D368301
GROUP LAB MEDICARE #
—
Enumeration date
12/07/2007
Last updated
11/20/2020
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