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Contact Information

PREMIER PEDIATRIC GROUP INC.
5386 COX SMITH ROAD
SUITE A
MASON, OH45040
 Phone: 513-770-3466
 Fax: 513-770-3467
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for PREMIER PEDIATRIC GROUP INC.

NPI Number 1093922072
LBN Legal business name PREMIER PEDIATRIC GROUP INC.
Authorized official BRADLEY JACKSON - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/17/2007
Last updated 08/22/2020 - About 6 years ago
Identifiers
OH Medicaid 2426771
OH Other 7200478 AETNA FOR ELIGABILITY
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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