Provider Demographics
NPI:1427322528
Name:PREMIER PAIN MANAGEMENT INC
Entity type:Organization
Organization Name:PREMIER PAIN MANAGEMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-674-3260
Mailing Address - Street 1:1250 E HALLANDALE BEACH BLVD
Mailing Address - Street 2:SUITE 602
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4634
Mailing Address - Country:US
Mailing Address - Phone:954-674-3260
Mailing Address - Fax:954-674-3310
Practice Address - Street 1:3993 LAWRENCEVILLE HWY NW
Practice Address - Street 2:SUITE 110
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-2897
Practice Address - Country:US
Practice Address - Phone:954-674-3260
Practice Address - Fax:954-674-3310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-07
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty