Organization
PREMIER FAMILY HEALTH CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACEY MOORE (MEMBER)
(479) 225-5429
Entity
Organization
Contact information
Practice address
310 N PROGRESS AVE, SILOAM SPRINGS, AR 72761-4093
(479) 225-5429
Mailing address
11005 N WEDINGTON BLACKTOP RD, LINCOLN, AR 72744-9459
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
06/05/2024
Last updated
12/06/2024
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