Premier Medical Development

Primary specialty

Clinic PharmacyTaxonomy code 3336C0002X

Legal business name

PREMIER MEDICAL DEVELOPMENT

Practice address

29155 Northwestern Hwy Ste 428
Southfield, MI 48034-1011

Phone

(877) 220-8411

NPI assigned

May 3, 2018

Organization subpart

No

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

Authorized official

Name

Anzour S Jallouqa

Title

Practice Manager

Phone

(877) 220-8411

Specialties & licenses 2

Addresses

Other names 3

• Premier MD Doing business as
• Premier MD DME Doing business as
• Premier MD Midwest Medical Lab Doing business as

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

{
    "created_epoch": "1525305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605484800000",
    "number": "1780173971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29155 NORTHWESTERN HWY STE 428",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29155 NORTHWESTERN HWY STE 428",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341011",
            "telephone_number": "877-220-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER MEDICAL DEVELOPMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-03",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A",
        "authorized_official_last_name": "JALLOUQA",
        "authorized_official_first_name": "ANZOUR",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "877-220-8411"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier MD",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Premier MD DME",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Premier MD Midwest Medical Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Preferred Urology Consultants, P.C
• Premier at Home Care LLC
• Premier Family Medicine PLLC
• Premier Health Network, LLC
• Premier Home Pharmacy Inc
• Premier Medical Equipment, LLC
• Premier Medical Massage
• Premier One Staffing
• Premier Staffing Group Agency L.L.C
• Premise Health of Michigan Medical PC

• Clinic Pharmacy in Southfield, MI
• Providers in Southfield, MI by specialty
• Clinic Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.