Premier Revenue Solutions LLC

Primary specialty

Supports Brokerage AgencyTaxonomy code 251X00000X

Legal business name

PREMIER REVENUE SOLUTIONS LLC

Practice address

1155 S Congress Ave Ste C
Palm Springs, FL 33406-5114

Phone

(561) 766-1300

Fax

(561) 693-0539

NPI assigned

Oct 13, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Tim Hansen

Title

Coo

Phone

(561) 766-1300

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604448000000",
    "number": "1003366063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 S CONGRESS AVE STE C",
            "city": "PALM SPRINGS",
            "state": "FL",
            "postal_code": "334065114",
            "telephone_number": "561-766-1300",
            "fax_number": "561-693-0539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 S CONGRESS AVE STE C",
            "city": "PALM SPRINGS",
            "state": "FL",
            "postal_code": "334065114",
            "telephone_number": "561-766-1300",
            "fax_number": "561-693-0539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER REVENUE SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-13",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "561-766-1300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.