PREMIER HEALTH MANAGEMENT, INC.

Provider Demographics

• NPI: 1538154760
• Name: PREMIER HEALTH MANAGEMENT, INC.
• Entity type: Organization
• Organization Name: PREMIER HEALTH MANAGEMENT, INC.
• Authorized Official - Title/Position: CEO
• Authorized Official - First Name: JAMES
• Authorized Official - Middle Name: W
• Authorized Official - Last Name: HARTMAN
• Authorized Official - Suffix: III
• Authorized Official - Phone: 251-473-1900
• Mailing Address - Street 1: 2880 DAUPHIN ST
• Mailing Address - City: MOBILE
• Mailing Address - State: AL
• Mailing Address - Zip Code: 36606-2457
• Mailing Address - Country: US
• Mailing Address - Phone: 251-473-1900
• Mailing Address - Fax: 251-470-8943
• Practice Address - Street 1: 2880 DAUPHIN ST
• Practice Address - City: MOBILE
• Practice Address - State: AL
• Practice Address - Zip Code: 36606-2457
• Practice Address - Country: US
• Practice Address - Phone: 251-473-1900
• Practice Address - Fax: 251-470-8943
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2005-09-14
• Last Update Date: 2011-12-12

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	207W00000X	Allopathic & Osteopathic Physicians	Ophthalmology		Group - Multi-Specialty
No	231H00000X	Speech, Language and Hearing Service Providers	Audiologist		Group - Multi-Specialty
No	237600000X	Speech, Language and Hearing Service Providers	Audiologist-Hearing Aid Fitter		Group - Multi-Specialty
No	207Y00000X	Allopathic & Osteopathic Physicians	Otolaryngology		Group - Multi-Specialty
No	152W00000X	Eye and Vision Services Providers	Optometrist		Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
MS	05203021	Medicaid
AL	529701060	Medicaid
MS	06328890	Medicaid
MS	09014534	Medicaid
AL	529701070	Medicaid
MS	01986218	Medicaid
MS	08375222	Medicaid
MS	08375222	Medicaid
AL	C00882	Medicare PIN
AL	529701060	Medicaid
MS	01986218	Medicaid
MS	09014534	Medicaid
AL	529701070	Medicaid
AL	I256	Medicare PIN