Healthcare Provider Details

I. General information

NPI: 1568580918
Provider Name (Legal Business Name): PREMIER HOME CARE, CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 01/08/2024
Certification Date: 01/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 TAYLOR STATION RD STE A
GAHANNA OH
43230-3587
US

IV. Provider business mailing address

8444 WHISPER TRCE
DELAWARE OH
43015-7118
US

V. Phone/Fax

Practice location:
  • Phone: 614-863-8950
  • Fax: 614-863-8980
Mailing address:
  • Phone: 614-327-7630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number StateNULL

VIII. Authorized Official

Name: VILAYPHONE THAWNGHMUNG
Title or Position: PRESIDENT
Credential:
Phone: 614-322-2242