1891812558 NPI number — PREMIER HOME HEALTH CARE SERVICES, INC

Table of content: (NPI 1891812558)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891812558 NPI number — PREMIER HOME HEALTH CARE SERVICES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PREMIER HOME HEALTH CARE SERVICES, INC
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:
6
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:
1891812558
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/21/2011
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:
71 BRADLEY RD
Provider Second Line Business Practice Location Address:
SUITE 7B
Provider Business Practice Location Address City Name:
MADISON
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06443-2662
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-245-4153
Provider Business Practice Location Address Fax Number:
203-245-4673
Provider Enumeration Date:
03/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GIANDURCO
Authorized Official First Name:
CATHERINE
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE VICE PRESIDENT
Authorized Official Telephone Number:
914-428-7722

Provider Taxonomy Codes

  • Taxonomy code: 251J00000X , with the licence number:  0005 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: 0005 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0005 . This is a "STATE LICENSE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com