| Premier Health S.c. | |
|
1540 Lyon Dr Neenah WI 54956-5069 | |
| (920) 727-4946 | |
| (920) 727-4956 |
| Full Name | Premier Health S.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1540 Lyon Dr, Neenah, Wisconsin |
| Authorized Official Name and Position | Ifueko Belinda Okundaye (PRESIDENT) |
| Authorized Official Contact | 9207274946 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Health S.c. 1540 Lyon Dr Neenah WI 54956-5069 Ph: (920) 727-4946 | Premier Health S.c. 1540 Lyon Dr Neenah WI 54956-5069 Ph: (920) 727-4946 |
| NPI Number | 1275549594 |
|---|---|
| Provider Enumeration Date | 07/31/2006 |
| Last Update Date | 05/17/2013 |
| Medicare PECOS PAC ID | 6709869266 |
|---|---|
| Medicare Enrollment ID | O20040608000356 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275549594 | NPI | - | NPPES |
| 32229200 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 37832 (Wisconsin) | Primary |
| Provider Name | Ifueko B Okundaye |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467460410 PECOS PAC ID: 9638152101 Enrollment ID: I20040609000226 |
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