| Premium Life Medical Center Llc | |
|
639 Beaver Ruin Rd Nw Ste A Lilburn GA 30047-3473 | |
| (678) 395-3443 | |
| (770) 837-2426 |
| Full Name | Premium Life Medical Center Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 639 Beaver Ruin Rd Nw Ste A, Lilburn, Georgia |
| Authorized Official Name and Position | Raymond Ramirez (DOCTOR MANAGER) |
| Authorized Official Contact | 6783953443 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premium Life Medical Center Llc 639 Beaver Ruin Rd Nw Ste A Lilburn GA 30047-3473 Ph: (678) 395-3443 | Premium Life Medical Center Llc 639 Beaver Ruin Rd Nw Ste A Lilburn GA 30047-3473 Ph: (678) 395-3443 |
| NPI Number | 1275233611 |
|---|---|
| Provider Enumeration Date | 03/06/2023 |
| Last Update Date | 03/06/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275233611 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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