Healthcare Provider Details

I. General information

NPI: 1982945184
Provider Name (Legal Business Name): PREMEIR HOME HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2013
Last Update Date: 03/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 E 27TH ST
MINNEAPOLIS MN
55407-1002
US

IV. Provider business mailing address

612 E 27TH ST
MINNEAPOLIS MN
55407-1002
US

V. Phone/Fax

Practice location:
  • Phone: 612-481-0934
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State

VIII. Authorized Official

Name: MR. IBRAHIM M ABUMUNYE
Title or Position: DIRECTOR
Credential:
Phone: 612-481-0934