Provider Demographics
NPI:1881882785
Name:PREMIER HEALTH ASSOCIATES, LLC
Entity type:Organization
Organization Name:PREMIER HEALTH ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:BOLLARD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:973-940-0423
Mailing Address - Street 1:532 LAFAYETTE RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871
Mailing Address - Country:US
Mailing Address - Phone:973-940-0423
Mailing Address - Fax:973-940-0399
Practice Address - Street 1:532 LAFAYETTE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871
Practice Address - Country:US
Practice Address - Phone:973-300-1248
Practice Address - Fax:973-579-5267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ112608Medicare PIN