Healthcare Provider Details
I. General information
NPI: 1891812558
Provider Name (Legal Business Name): PREMIER HOME HEALTH CARE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/26/2007
Last Update Date: 09/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
71 BRADLEY RD SUITE 7B
MADISON CT
06443-2662
US
IV. Provider business mailing address
445 HAMILTON AVE 10TH FLOOR
WHITE PLAINS NY
10601-1807
US
V. Phone/Fax
- Phone: 203-245-4153
- Fax: 203-245-4673
- Phone: 914-428-7722
- Fax: 914-428-2404
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | 0005 |
| License Number State | CT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251J00000X |
| Taxonomy | Nursing Care Agency |
| License Number | 0005 |
| License Number State | CT |
VIII. Authorized Official
Name: MS.
CATHERINE
GIANDURCO
Title or Position: EXECUTIVE VICE PRESIDENT
Credential:
Phone: 914-428-7722