| Premier Health,p.a. | |
|
6861 Upper Afton Rd Suite 102 Woodbury MN 55125-4417 | |
| (651) 739-1905 | |
| (651) 738-5979 |
| Full Name | Premier Health,p.a. |
|---|---|
| Speciality | Clinic/Center |
| Location | 6861 Upper Afton Rd, Woodbury, Minnesota |
| Authorized Official Name and Position | David Martin Witte (PRESIDENT/OWNER) |
| Authorized Official Contact | 6517391905 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Health,p.a. 6861 Upper Afton Rd Suite 102 Woodbury MN 55125-4417 Ph: (651) 739-1905 | Premier Health,p.a. 6861 Upper Afton Rd Suite 102 Woodbury MN 55125-4417 Ph: (651) 739-1905 |
| NPI Number | 1619163904 |
|---|---|
| Provider Enumeration Date | 09/20/2007 |
| Last Update Date | 09/20/2007 |
| Medicare PECOS PAC ID | 9830289644 |
|---|---|
| Medicare Enrollment ID | O20071217000808 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619163904 | NPI | - | NPPES |
| 990727100 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 1584 (Minnesota) | Primary |
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