Organization
PREMIER INTEGRATED MEDICAL ASSOC LTD
Active
Other names
PriMed Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK A COUCH MD (PRESIDENT)
(937) 898-3600
Entity
Organization
Contact information
Practice address
4000 MIAMISBURG CENTERVILLE RD, SUITE 104, MIAMISBURG, OH 45342
(937) 859-1117
(937) 859-9038
Mailing address
4700 SMITH RD, SUITE A, CINCINNATI, OH 45212-2787
(513) 619-6819
(513) 645-2393
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2178558
—
OH
01
—
314422758001
TRICARE GROUP NUMBER
—
01
—
CA2478
MEDICARE RR GROUP NUMBER
—
Enumeration date
04/28/2006
Last updated
12/30/2009
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