| Premiere Quality Health Center Inc | |
|
12048 Grand River Ave Detroit MI 48204-1836 | |
| (313) 635-5978 | |
| (313) 635-2171 |
| Full Name | Premiere Quality Health Center Inc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 12048 Grand River Ave, Detroit, Michigan |
| Authorized Official Name and Position | Esha Dushon Price (NURSE PRACTITIONER) |
| Authorized Official Contact | 3136355978 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premiere Quality Health Center Inc 12048 Grand River Ave Detroit MI 48204-1836 Ph: (313) 491-0003 | Premiere Quality Health Center Inc 12048 Grand River Ave Detroit MI 48204-1836 Ph: (313) 635-5978 |
| NPI Number | 1184375362 |
|---|---|
| Provider Enumeration Date | 01/10/2022 |
| Last Update Date | 12/07/2023 |
| Certification Date | 12/07/2023 |
| Medicare PECOS PAC ID | 2567854524 |
|---|---|
| Medicare Enrollment ID | O20241227000928 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184375362 | NPI | - | NPPES |
| Provider Name | Esha Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790335263 PECOS PAC ID: 2567894959 Enrollment ID: I20191125001113 |
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