Provider Demographics
NPI:1235895830
Name:PREMIER PAIN AND SPINE, LLC
Entity type:Organization
Organization Name:PREMIER PAIN AND SPINE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:LAVENDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-203-4844
Mailing Address - Street 1:3105 STEELE STATION RD
Mailing Address - Street 2:
Mailing Address - City:RAINBOW CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35906-8722
Mailing Address - Country:US
Mailing Address - Phone:256-203-4844
Mailing Address - Fax:256-459-5218
Practice Address - Street 1:3015 STEELE STATION RD
Practice Address - Street 2:
Practice Address - City:RAINBOW CITY
Practice Address - State:AL
Practice Address - Zip Code:35906-8722
Practice Address - Country:US
Practice Address - Phone:256-203-4844
Practice Address - Fax:256-459-5218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-09
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain