Provider Demographics
NPI:1871885319
Name:PREMIER HEALTH SPECIALISTS INC
Entity type:Organization
Organization Name:PREMIER HEALTH SPECIALISTS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-435-4263
Mailing Address - Street 1:5900 LONG MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-9687
Mailing Address - Country:US
Mailing Address - Phone:513-420-3773
Mailing Address - Fax:513-727-2539
Practice Address - Street 1:5900 LONG MEADOW DR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45005-9687
Practice Address - Country:US
Practice Address - Phone:513-420-3773
Practice Address - Fax:513-727-2539
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PREMIER HEALTH SPECIALISTS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-05-03
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0052125Medicaid
OH0052125Medicaid