Healthcare Provider Details

I. General information

NPI: 1508714148
Provider Name (Legal Business Name): PREMIER WAY HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2026
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17325 EUCLID AVE STE 3029A
CLEVELAND OH
44112-1255
US

IV. Provider business mailing address

17325 EUCLID AVE STE 3029A
CLEVELAND OH
44112-1255
US

V. Phone/Fax

Practice location:
  • Phone: 216-644-2092
  • Fax: 216-274-9911
Mailing address:
  • Phone: 216-644-2092
  • Fax: 216-274-9911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: ALVIN FOMBY JR.
Title or Position: CEO
Credential:
Phone: 216-644-2092