Healthcare Provider Details

I. General information

NPI: 1912862905
Provider Name (Legal Business Name): PREMIER MOBILE CARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2025
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 BATTLECREST DR
DECATUR GA
30034-2600
US

IV. Provider business mailing address

2901 BATTLECREST DR
DECATUR GA
30034-2600
US

V. Phone/Fax

Practice location:
  • Phone: 510-755-8590
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH VILLA
Title or Position: OWNER
Credential:
Phone: 510-755-8590