Healthcare Provider Details

I. General information

NPI: 1336788637
Provider Name (Legal Business Name): PREMIER HEALTHCARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2020
Last Update Date: 01/03/2020
Certification Date: 01/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

907 IRVINGTON PL
CHESTER PA
19013-5215
US

IV. Provider business mailing address

907 IRVINGTON PL
CHESTER PA
19013-5215
US

V. Phone/Fax

Practice location:
  • Phone: 267-303-4592
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: SHAKIRA WILSON
Title or Position: OWNER
Credential:
Phone: 267-303-4592