Provider Demographics
NPI:1174089163
Name:PREMIER HEALTHCARE SERVICES, LLC
Entity type:Organization
Organization Name:PREMIER HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:THORNSON
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:774-202-7049
Mailing Address - Street 1:85 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02724-3348
Mailing Address - Country:US
Mailing Address - Phone:774-526-4241
Mailing Address - Fax:
Practice Address - Street 1:77 WOLCOTT AVE
Practice Address - Street 2:
Practice Address - City:DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-2459
Practice Address - Country:US
Practice Address - Phone:774-202-7049
Practice Address - Fax:774-202-2839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-14
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty