| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 07/22/2013 |
| Last Update Date | 10/02/2013 |
| Medicare PECOS PAC ID | 1951529791 |
|---|---|
| Medicare Enrollment ID | O20140820001468 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477995231 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
| Provider Name | Chukwunomnso Nwaka Dennar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326153131 PECOS PAC ID: 6406876408 Enrollment ID: I20080501000197 |
| Provider Name | Princess Dennar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003906298 PECOS PAC ID: 5294733556 Enrollment ID: I20080501000208 |
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