| Premier Medical Integration Llc | |
|
11030 N Tatum Blvd Ste 102 Phoenix AZ 85028-6073 | |
| (602) 369-4409 | |
| Not Available |
| Full Name | Premier Medical Integration Llc |
|---|---|
| Speciality | General Practice |
| Location | 11030 N Tatum Blvd Ste 102, Phoenix, Arizona |
| Authorized Official Name and Position | Laurie Ann Mcfarlane (PRESIDENT) |
| Authorized Official Contact | 6023694409 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Medical Integration Llc 11030 N Tatum Blvd Ste 102 Phoenix AZ 85028-6073 Ph: (602) 369-4409 | Premier Medical Integration Llc 11030 N Tatum Blvd Ste 102 Phoenix AZ 85028-6073 Ph: (602) 369-4409 |
| NPI Number | 1306419056 |
|---|---|
| Provider Enumeration Date | 07/21/2021 |
| Last Update Date | 07/21/2021 |
| Medicare PECOS PAC ID | 0143690321 |
|---|---|
| Medicare Enrollment ID | O20230104001699 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306419056 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Jay D Mcfarlane |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1669477535 PECOS PAC ID: 8123015351 Enrollment ID: I20040428001412 |
| Provider Name | Kathy Nelson Hawks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841964251 PECOS PAC ID: 7315317500 Enrollment ID: I20230104002294 |
| Provider Name | Bryan Mcfarlane |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1639815558 PECOS PAC ID: 9931579737 Enrollment ID: I20230111001855 |
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