| Premier Health Llc | |
|
13 Town West Rd Ste B-3 Plymouth NH 03264-3428 | |
| (603) 945-8048 | |
| (603) 945-7110 |
| Full Name | Premier Health Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 13 Town West Rd Ste B-3, Plymouth, New Hampshire |
| Authorized Official Name and Position | Mariya Kogan (CEO) |
| Authorized Official Contact | 9175665997 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Health Llc 461 Main St Ste 6c Franconia NH 03580-4835 Ph: () - | Premier Health Llc 13 Town West Rd Ste B-3 Plymouth NH 03264-3428 Ph: (603) 945-8048 |
| NPI Number | 1760969679 |
|---|---|
| Provider Enumeration Date | 07/24/2018 |
| Last Update Date | 11/14/2023 |
| Certification Date | 11/14/2023 |
| Medicare PECOS PAC ID | 1153757117 |
|---|---|
| Medicare Enrollment ID | O20200701002147 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760969679 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| 367500000X | Nurse Anesthetist, Certified Registered | (* (Not Available)) | Secondary |
| Provider Name | Richard K Nasstrom |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144665712 PECOS PAC ID: 3779859335 Enrollment ID: I20171026000304 |
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