Healthcare Provider Details

I. General information

NPI: 1902841000
Provider Name (Legal Business Name): PREMIER HOME HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 04/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

487A NORTH MAIN ST SUITE #2
THAYNE WY
83127
US

IV. Provider business mailing address

PO BOX 999
THAYNE WY
83127
US

V. Phone/Fax

Practice location:
  • Phone: 307-883-5500
  • Fax: 307-883-5501
Mailing address:
  • Phone: 307-883-5500
  • Fax: 307-883-5501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number06202
License Number StateWY

VIII. Authorized Official

Name: MRS. CATHERINE E COLE
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 307-883-5500