Premium Enterprises Inc

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

22910 Issued in OK

Legal business name

PREMIUM ENTERPRISES INC

Practice address

1104 E State Highway 152 Unit 1
Mustang, OK 73064-5116

Phone

(855) 541-2862

Fax

(405) 716-4808

NPI assigned

Aug 22, 2017

Organization subpart

No

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

Authorized official

Name

Muhammad Ghias, MD

Title

Owner

Phone

(855) 541-2862

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1503360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503360000000",
    "number": "1013433028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15509 JUNIPER DR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730138841",
            "telephone_number": "855-541-2862",
            "fax_number": "405-716-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 E STATE HIGHWAY 152 UNIT 1",
            "city": "MUSTANG",
            "state": "OK",
            "postal_code": "730645116",
            "telephone_number": "855-541-2862",
            "fax_number": "405-716-4808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-22",
        "last_updated": "2017-08-22",
        "status": "A",
        "authorized_official_last_name": "GHIAS",
        "authorized_official_first_name": "MUHAMMAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "855-541-2862",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": "OK",
            "license": "22910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200080810A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Lynn Poage, OD
• Fallon Rae Potter
• Lacey Potter
• Roger Goel Potts, DDS
• Stefanie Renae Powell, RBT
• Bailey Price
• Geneva Prince
• Hannah Prollock
• William Purcell, PHARMD
• Pure Divergence

• Hospitalist Physician in Mustang, OK
• Providers in Mustang, OK by specialty
• Hospitalist Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2017; 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.