| Premier Health & Wellness, Llc | |
|
11801 N Tatum Blvd Ste 128 Phoenix AZ 85028-1620 | |
| (602) 795-9980 | |
| Not Available |
| Full Name | Premier Health & Wellness, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 11801 N Tatum Blvd Ste 128, Phoenix, Arizona |
| Authorized Official Name and Position | Sonia A Godbole (MEMBER) |
| Authorized Official Contact | 6027959980 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Health & Wellness, Llc 11801 N Tatum Blvd Ste 128 Phoenix AZ 85028-1620 Ph: (602) 388-1343 | Premier Health & Wellness, Llc 11801 N Tatum Blvd Ste 128 Phoenix AZ 85028-1620 Ph: (602) 795-9980 |
| NPI Number | 1053710590 |
|---|---|
| Provider Enumeration Date | 08/21/2014 |
| Last Update Date | 09/12/2023 |
| Certification Date | 09/12/2023 |
| Medicare PECOS PAC ID | 3072801224 |
|---|---|
| Medicare Enrollment ID | O20161004002031 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053710590 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Sonia A Godbole |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689752701 PECOS PAC ID: 9638117807 Enrollment ID: I20050419000534 |
| Provider Name | Alpa A Sanghvi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174610976 PECOS PAC ID: 3678574373 Enrollment ID: I20070123000678 |
| Provider Name | Supriya Nair |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841328077 PECOS PAC ID: 4688777162 Enrollment ID: I20070321000678 |
| Provider Name | Shaili K Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538171459 PECOS PAC ID: 2264690254 Enrollment ID: I20120222000393 |
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