1033489919 NPI number — PREMIER HOME HEALTH CARE SERVICES

Table of content: (NPI 1033489919)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033489919 NPI number — PREMIER HOME HEALTH CARE SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PREMIER HOME HEALTH CARE SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033489919
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/13/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
445 HAMILTON AVE
Provider Second Line Business Mailing Address:
10TH FLOOR
Provider Business Mailing Address City Name:
WHITE PLAINS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10601-1807
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-428-7722
Provider Business Mailing Address Fax Number:
914-428-2404

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2125 CENTER AVE
Provider Second Line Business Practice Location Address:
SUITE 207
Provider Business Practice Location Address City Name:
FORT LEE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07024-5859
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-461-9595
Provider Business Practice Location Address Fax Number:
201-461-9830
Provider Enumeration Date:
01/09/2012

Additional Information

Authorized Official

Authorized Official Last Name:
TURCHAN
Authorized Official First Name:
GREGORY
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF OPERATING OFFICER
Authorized Official Telephone Number:
914-428-7722

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  HP0231608 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251J00000X , with the licence number: HP0231608 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: HP0231608 . This is a "LICENSE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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