Premier Medical Associates, P.C.

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

OS007871L Issued in PA

Legal business name

PREMIER MEDICAL ASSOCIATES, P.C.

Practice address

4044 Route 130
Suite 200
Irwin, PA 15642-7830

Phone

(724) 744-2500

NPI assigned

Feb 9, 2007

Organization subpart

Yes

Parent organization

MEDVANTX, INC.As reported in NPPES

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

Authorized official

Name

Mr. Scott Peterson

Title

Cfo

Phone

(858) 625-2990

Specialties & licenses 1

Addresses

Part of

Tri - State Medical Group Inc

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489708800000",
    "number": "1043351273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9276 SCRANTON RD",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921217701",
            "telephone_number": "858-625-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4044 ROUTE 130",
            "address_2": "SUITE 200",
            "city": "IRWIN",
            "state": "PA",
            "postal_code": "156427830",
            "telephone_number": "724-744-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER MEDICAL ASSOCIATES, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2007-02-09",
        "last_updated": "2017-03-17",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "858-625-2990",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "PA",
            "license": "OS007871L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Polakovsky
• Jennifer Polando
• Catherine Louise Ponterio, MS, BCBA, LBS
• Michael David Poskus, LCSW
• Juanita Powell
• Hayley Principe
• Proactive Living Homecare LLC
• Jodi Lynn Procida
• Ashlee Pugh
• Karley Pulkownik

• Non-Pharmacy Dispensing Site in Irwin, PA
• Providers in Irwin, PA by specialty
• Non-Pharmacy Dispensing Site in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.