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Premium Life Medical Center Llc
Primary Care Clinic/Center in Lilburn, Georgia
NPI 1275233611

Premium Life Medical Center Llc is a Primary Care Clinic/Center based in Lilburn, GA and is specialized in Primary Care. Premium Life Medical Center Llc practices in Lilburn, GA. The NPI Number for Premium Life Medical Center Llc is 1275233611 and holds a License No. (Georgia).

The current practice location address for Premium Life Medical Center Llc is 639 Beaver Ruin Rd Nw Ste A, Lilburn, GA and can be reached out via phone at 678-395-3443 and via fax at 770-837-2426.

Location: 639 Beaver Ruin Rd Nw Ste A, Lilburn, GA, 30047-3473
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1275233611
Provider Name
Premium Life Medical Center Llc
Credential
Provider Entity Type
Organization
Address
639 Beaver Ruin Rd Nw Ste A, Lilburn, GA, 30047-3473
Phone Number
678-395-3443
Fax Number
770-837-2426
Provider Enumeration Date
03/06/2023
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
639 Beaver Ruin Rd Nw Ste A
City
Lilburn
State
Georgia
Zip
30047-3473
Phone Number
678-395-3443
Fax Number
770-837-2426
person
Provider Business Mailing Address Details
Address
639 Beaver Ruin Rd Nw Ste A
City
Lilburn
State
Georgia
Zip
30047-3473
Phone Number
678-395-3443
Fax Number
770-837-2426
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
261QP2300X
License No.
()
Definition
Definition to come...
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