| Premier Medical Clinic | |
|
315 E Ash St Perry FL 32347-2029 | |
| (850) 584-3278 | |
| (850) 584-8171 |
| Full Name | Premier Medical Clinic |
|---|---|
| Speciality | Internal Medicine |
| Location | 315 E Ash St, Perry, Florida |
| Authorized Official Name and Position | Khalil M Afsh (OWNER) |
| Authorized Official Contact | 8505843278 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Medical Clinic 315 E Ash St Perry FL 32347-2029 Ph: (850) 584-3278 | Premier Medical Clinic 315 E Ash St Perry FL 32347-2029 Ph: (850) 584-3278 |
| NPI Number | 1518926799 |
|---|---|
| Provider Enumeration Date | 03/17/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 9436116522 |
|---|---|
| Medicare Enrollment ID | O20041209001018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518926799 | NPI | - | NPPES |
| CB3685 | Other | FL | RAILROAD MCR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Abdul H Sofi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205885613 PECOS PAC ID: 0749287977 Enrollment ID: I20061101000479 |
| Provider Name | Diane Dodgen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134117385 PECOS PAC ID: 8426962176 Enrollment ID: I20071121000031 |
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