Provider Demographics
NPI:1992721328
Name:PREMIER MEDICAL EQUIPMENT
Entity type:Organization
Organization Name:PREMIER MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARINE
Authorized Official - Middle Name:
Authorized Official - Last Name:TER-GABRIELYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-446-0636
Mailing Address - Street 1:7148 FOOTHILL BLVD
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-2717
Mailing Address - Country:US
Mailing Address - Phone:818-446-0436
Mailing Address - Fax:
Practice Address - Street 1:7148 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:TUJUNGA
Practice Address - State:CA
Practice Address - Zip Code:91042-2717
Practice Address - Country:US
Practice Address - Phone:818-446-0436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies