Healthcare Provider Details

I. General information

NPI: 1033489919
Provider Name (Legal Business Name): PREMIER HOME HEALTH CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2012
Last Update Date: 07/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2125 CENTER AVE SUITE 207
FORT LEE NJ
07024-5859
US

IV. Provider business mailing address

445 HAMILTON AVE 10TH FLOOR
WHITE PLAINS NY
10601-1807
US

V. Phone/Fax

Practice location:
  • Phone: 201-461-9595
  • Fax: 201-461-9830
Mailing address:
  • Phone: 914-428-7722
  • Fax: 914-428-2404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHP0231608
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberHP0231608
License Number StateNJ

VIII. Authorized Official

Name: MR. GREGORY TURCHAN
Title or Position: CHIEF OPERATING OFFICER
Credential: MSW, MPA
Phone: 914-428-7722