Healthcare Provider Details

I. General information

NPI: 1780603134
Provider Name (Legal Business Name): PREMIER HOME HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 05/19/2020
Certification Date: 05/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1016 E. SHAWNTEL SMITH BOULEVARD SUITE 2
MULDROW OK
74948
US

IV. Provider business mailing address

1016 E. SHAWNTEL SMITH BOULEVARD
MULDROW OK
74948
US

V. Phone/Fax

Practice location:
  • Phone: 918-427-1900
  • Fax: 877-700-6210
Mailing address:
  • Phone: 918-427-1900
  • Fax: 918-427-9967

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: MARY RENEE ROGERS
Title or Position: ADMINISTRATOR/ OWNER
Credential: REGISTERED NURSE
Phone: 918-427-1900