Premium Wellness And Primary Care

LBN: Premium Wellness And Primary Care
Premium Wellness And Primary Care is an health care organization with primary practice located at 308 Pomona Dr Ste A , Greensboro NC 27407-1644. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Health Service, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Primary Care is the primary health care specialty. Premium Wellness And Primary Care can be contacted via phone (336) 553-0793, or through Zellous, Monica Dianne via phone (336) 553-0793.

Contact Information

Primary practice address
308 Pomona Dr Ste A Greensboro NC 27407-1644
Phone: (336) 553-0793
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Zellous, Monica Dianne
Phone: (336) 553-0793

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Health Service 261QH0100X 5004483 North Carolina
Ambulatory Health Care Facilities / Health Service 261QH0100X 5006433 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X

Profile Details

NPI number 1336599547
LBN Legal business name Premium Wellness And Primary Care
DBA Doing business as
Authorized official Zellous, Monica Dianne
Entity Organization
Organization subpart 1 No
Enumeration date Jun 18th, 2016
Last updated Jul 12th, 2024 - about 5 months ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336599547 NPPES
North Carolina MEDICAID 8975633

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