Premier Aesthetics
Specialist in Lithonia, GA. Organization (NPI-2).
NPI number1780968115
StatusActive
Last updated in NPPESApr 22, 2015
Details
- NPI
- 1780968115
- Entity type
- Organization (NPI-2)
- Legal business name
- Premier Aesthetics
- Organization subpart
- No
- Enumeration date
- Oct 4, 2011
- Last updated
- Apr 22, 2015
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | 08518 | GA | Yes |
Practice location
5404 Hillandale Park CtLithonia, GA 30058-8803
Phone 678-418-6990 · Fax 678-418-6986
Mailing address
5404 Hillandale Park CtLithonia, GA 30058-8803
Phone 678-418-6990 · Fax 678-418-6986
Authorized official
Angela Copeland
Practice Manager
6786896485
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