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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 (INTERIUM CEO)
(440) 895-5056
Entity
Organization

Contact information

Practice address
25200 CENTER RIDGE RD, SUITE 3100, WESTLAKE, OH 44145-4141
(440) 331-4559
(440) 333-2935
Mailing address
24500 CENTER RIDGE RD STE 375, WESTLAKE, OH 44145-5631
(440) 895-5056
(440) 333-2935

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0791AS
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1942483433
ASC NPI GROUP #
05
2040482
OH
01
3610861
ASC GROUP MEDICARE #
01
4511
GROUP RR MEDICARE
01
490003414
RAILROAD MEDICARE GROUP #
01
D368301
GROUP IND DIAGNOSTICS LAB
Enumeration date
12/07/2007
Last updated
10/30/2020
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