Premier Estates of Dublin LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PREMIER ESTATES OF DUBLIN LLC

Practice address

1634 Telfair St
Dublin, GA 31021-3115

Phone

(478) 272-1133

Fax

(478) 272-4401

NPI assigned

May 1, 2015

Organization subpart

No

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

Authorized official

Name

Gregory Shayne Bench

Title

Cfo

Phone

(941) 758-4745

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Raghu N Lolabhattu, MD

  • Internal Medicine Physician
  • East Dublin, GA
  • NPI 1851397368
  NPD (past)
• Albert Warren Jr., MD

  • Family Medicine Physician
  • Columbia, SC
  • NPI 1871770412
  NPD (past)

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

{
    "created_epoch": "1430438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450828800000",
    "number": "1457738130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5265 OFFICE PARK BLVD",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342033441",
            "telephone_number": "941-758-4745",
            "fax_number": "941-751-2135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1634 TELFAIR ST",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310213115",
            "telephone_number": "478-272-1133",
            "fax_number": "478-272-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER ESTATES OF DUBLIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-01",
        "last_updated": "2015-12-23",
        "status": "A",
        "authorized_official_last_name": "BENCH",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "SHAYNE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "941-758-4745"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000141281A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Celia Potts, PHARMD
• Anna Haralson Powell, NP-C
• Joyce Yvonne Powell, RN
• Samantha Powell, PHARM.D.
• Preferred Treatment Center, LLC
• Amber Price, NP
• Breanna Price, M.ED., CCC-SLP
• James W Price, M.D.
• Toni Price, LMSW
• Providence OBGYN LLC

• All providers in Dublin, GA
• Skilled Nursing Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2015; 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.