| NPI | 1780173971 |
|---|---|
| Doing Business As | PREMIER MD DME |
| Doing Business As | PREMIER MD |
| Doing Business As | PREMIER MD MIDWEST MEDICAL LAB |
| Entity Type | Organization |
| Authorized Contact | ANZOUR S JALLOUQA Practice Manager 877-220-8411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2020-11-16 |