Organization
PREMIER MEDICAL SUPPLY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLETTE RADCLIFFE (PRESIDENT)
(915) 504-3111
Entity
Organization
Contact information
Practice address
1545 GOODYEAR DR STE D, EL PASO, TX 79936-6063
(915) 594-3333
(915) 594-3043
Mailing address
1545 GOODYEAR DR STE D, EL PASO, TX 79936-6063
(915) 594-3333
(915) 594-3043
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
297995701
—
TX
Enumeration date
07/26/2011
Last updated
06/11/2024
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