Provider Demographics
NPI:1285299131
Name:PERMIAN PREMIER HEALTH SERVICES INC
Entity type:Organization
Organization Name:PERMIAN PREMIER HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:DEMKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-467-1072
Mailing Address - Street 1:PO BOX 24573
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4496
Mailing Address - Country:US
Mailing Address - Phone:855-660-0300
Mailing Address - Fax:
Practice Address - Street 1:520 E 6TH ST
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-4527
Practice Address - Country:US
Practice Address - Phone:432-582-8053
Practice Address - Fax:432-582-8054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-07
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty