| Premiere Health And Wellness Medical Center | |
|
2609 N Duke St Suite 403 Durham NC 27704-3048 | |
| (919) 416-4700 | |
| (919) 416-0821 |
| Full Name | Premiere Health And Wellness Medical Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 2609 N Duke St, Durham, North Carolina |
| Authorized Official Name and Position | Venus Idette Pitts (OWNER) |
| Authorized Official Contact | 9194164700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premiere Health And Wellness Medical Center 2609 N Duke St Suite 403 Durham NC 27704-3048 Ph: (919) 416-4700 | Premiere Health And Wellness Medical Center 2609 N Duke St Suite 403 Durham NC 27704-3048 Ph: (919) 416-4700 |
| NPI Number | 1942578554 |
|---|---|
| Provider Enumeration Date | 12/09/2011 |
| Last Update Date | 03/13/2015 |
| Medicare PECOS PAC ID | 4082934898 |
|---|---|
| Medicare Enrollment ID | O20150519001477 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942578554 | NPI | - | NPPES |
| 2026035A | Other | NC | MEDICARE ID |
| 89136E4 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 145584 (North Carolina) | Primary |
| 208000000X | Pediatrics | 145584 (North Carolina) | Secondary |
| Provider Name | Venus I Pitts |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740217801 PECOS PAC ID: 7618956269 Enrollment ID: I20040716000504 |
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