Healthcare Provider Details

I. General information

NPI: 1457042376
Provider Name (Legal Business Name): PREMIER TORCH HEALTHCARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2023
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1604 WOLF CREEK DR
ARLINGTON TX
76018-3053
US

IV. Provider business mailing address

1604 WOLF CREEK DR
ARLINGTON TX
76018-3053
US

V. Phone/Fax

Practice location:
  • Phone: 682-353-8154
  • Fax: 254-218-1490
Mailing address:
  • Phone: 682-353-8154
  • Fax: 254-218-1490

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 Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State

VIII. Authorized Official

Name: PRINCESS ENAHORO
Title or Position: ADMINISTRATOR
Credential:
Phone: 682-353-8154