Healthcare Provider Details

I. General information

NPI: 1205126869
Provider Name (Legal Business Name): PREEMINENT CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2011
Last Update Date: 04/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CINNAMINSON AVE SUITE 202
PALMYRA NJ
08065-2500
US

IV. Provider business mailing address

700 CINNAMINSON AVE SUITE 202
PALMYRA NJ
08065-2500
US

V. Phone/Fax

Practice location:
  • Phone: 856-829-0034
  • Fax: 856-829-0223
Mailing address:
  • Phone: 856-829-0034
  • Fax: 856-829-0223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. MIKE SULLIVAN
Title or Position: PRESIDENT
Credential:
Phone: 856-829-0034