Healthcare Provider Details

I. General information

NPI: 1679654511
Provider Name (Legal Business Name): PREMIER HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 QUITMAN ST
PITTSBURG TX
75686-1362
US

IV. Provider business mailing address

148 QUITMAN ST
PITTSBURG TX
75686-1362
US

V. Phone/Fax

Practice location:
  • Phone: 888-763-3274
  • Fax: 877-667-0881
Mailing address:
  • Phone: 888-763-3274
  • Fax: 877-667-0681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number016257
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: HOLLYE ELAINE ROSEWELL
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 888-763-3274