Premium Care Medical Center, Llc | |
3570 Holiday Dr Suites 3-7 New Orleans LA 70114-8287 | |
(504) 361-4203 | |
(504) 361-4204 |
Full Name | Premium Care Medical Center, Llc |
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Speciality | Internal Medicine |
Location | 3570 Holiday Dr, New Orleans, Louisiana |
Authorized Official Name and Position | Princess Dennar (CEO/MANAGING PARTNER) |
Authorized Official Contact | 5043614203 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Premium Care Medical Center, Llc 3570 Holiday Dr Suites 3-7 New Orleans LA 70114-8287 Ph: (504) 361-4203 | Premium Care Medical Center, Llc 3570 Holiday Dr Suites 3-7 New Orleans LA 70114-8287 Ph: (504) 361-4203 |
NPI Number | 1477995231 |
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Provider Enumeration Date | 07/22/2013 |
Last Update Date | 10/02/2013 |
Medicare PECOS PAC ID | 1951529791 |
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Medicare Enrollment ID | O20140820001468 |
Identifier | Type | State | Issuer |
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1477995231 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | (* (Not Available)) | Primary |
208000000X | Pediatrics | (* (Not Available)) | Secondary |
Provider Name | Chukwunomnso Nwaka Dennar |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1326153131 PECOS PAC ID: 6406876408 Enrollment ID: I20080501000197 |
Provider Name | Princess Dennar |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1003906298 PECOS PAC ID: 5294733556 Enrollment ID: I20080501000208 |
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