| Premiere Medical Llc | |
|
6877 N Seville Ave Milwaukee WI 53209-2645 | |
| (414) 247-9005 | |
| (414) 247-9004 |
| Full Name | Premiere Medical Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 6877 N Seville Ave, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Maureen Tsogbe (PRESIDENT/OWNER) |
| Authorized Official Contact | 3019089136 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premiere Medical Llc Po Box 639 Thiensville WI 53092-0639 Ph: (414) 247-9005 | Premiere Medical Llc 6877 N Seville Ave Milwaukee WI 53209-2645 Ph: (414) 247-9005 |
| NPI Number | 1033625983 |
|---|---|
| Provider Enumeration Date | 12/14/2017 |
| Last Update Date | 12/14/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033625983 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 4763 (Wisconsin) | Primary |
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