Provider Demographics
NPI:1033095401
Name:PREMIER RHEUMATOLOGY
Entity type:Organization
Organization Name:PREMIER RHEUMATOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:SCHARTESS
Authorized Official - Middle Name:
Authorized Official - Last Name:CULPEPPER PACE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-753-7309
Mailing Address - Street 1:801 BLACK DIAMOND DR
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-8821
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1129 HOSPITAL DR STE 1A
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-6393
Practice Address - Country:US
Practice Address - Phone:305-753-7309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty