Organization
PREMIER MEDICAL DEVELOPMENT
Active
Other names
Premier MD Midwest Medical Lab, Premier MD DME, Premier MD
Organization subpart
No
Provider details
NPI number
Authorized official
ANZOUR S JALLOUQA (PRACTICE MANAGER)
(877) 220-8411
Entity
Organization
Contact information
Practice address
29155 NORTHWESTERN HWY STE 428, SOUTHFIELD, MI 48034-1011
(877) 220-8411
Mailing address
29155 NORTHWESTERN HWY STE 428, SOUTHFIELD, MI 48034-1011
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0002X
Clinic Pharmacy
Primary
—
—
Other
Enumeration date
05/03/2018
Last updated
11/16/2020
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