Premium Health, Inc. | |
620 Foster Ave Ste 200 Premium Health, Inc. Brooklyn NY 11230-1399 | |
(718) 407-7300 | |
(718) 859-5717 |
Full Name | Premium Health, Inc. |
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Speciality | Clinic/Center |
Location | 620 Foster Ave Ste 200, Brooklyn, New York |
Authorized Official Name and Position | Carol Dooley (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 7184077300 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Premium Health, Inc. 620 Foster Ave Premium Health, Inc. Brooklyn NY 11230-1399 Ph: (718) 407-7300 | Premium Health, Inc. 620 Foster Ave Ste 200 Premium Health, Inc. Brooklyn NY 11230-1399 Ph: (718) 407-7300 |
NPI Number | 1609129402 |
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Provider Enumeration Date | 10/18/2012 |
Last Update Date | 12/12/2013 |
Medicare PECOS PAC ID | 4981830023 |
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Medicare Enrollment ID | O20131120001513 |
Identifier | Type | State | Issuer |
---|---|---|---|
1609129402 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 000000 (New York) | Primary |
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