Healthcare Provider Details

I. General information

NPI: 1578696233
Provider Name (Legal Business Name): PREMIER HOMECARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4096 HICKORY BLVD
GRANITE FALLS NC
28630-8372
US

IV. Provider business mailing address

4096 HICKORY BLVD
GRANITE FALLS NC
28630-8372
US

V. Phone/Fax

Practice location:
  • Phone: 828-396-9111
  • Fax: 828-396-9112
Mailing address:
  • Phone: 828-396-9111
  • Fax: 828-396-9112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License NumberHC3386
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberHC3386
License Number StateNC

VIII. Authorized Official

Name: MRS. BETH HATTON JARDON
Title or Position: DIRECTOR
Credential: R.N.
Phone: 828-396-9111