Provider Demographics
NPI:1861249708
Name:PREMIER EXPRESS CARE LLC
Entity type:Organization
Organization Name:PREMIER EXPRESS CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:COLOSIMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-242-9719
Mailing Address - Street 1:171 MINOR RD
Mailing Address - Street 2:
Mailing Address - City:SUMMERHILL
Mailing Address - State:PA
Mailing Address - Zip Code:15958-4000
Mailing Address - Country:US
Mailing Address - Phone:814-242-9719
Mailing Address - Fax:
Practice Address - Street 1:215 W. LOYALHANNA STREET
Practice Address - Street 2:
Practice Address - City:LIGONIER
Practice Address - State:PA
Practice Address - Zip Code:15658
Practice Address - Country:US
Practice Address - Phone:724-875-5446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care