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General NPI Number Information
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NPI Number | 1013910793
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Entity Type | Organization
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Legal Business Name | PREMIER SUPPORT SERVICES, INC.
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 06/20/2024
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Provider Practice Location Address
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Address Line | 2482 BRIGHTS PIKE
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City | MORRISTOWN
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State | TN
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Zip | 37814-6315
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Country | US
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Telephone | 423-587-8771
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Fax | 423-587-8773
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Provider Business Mailing Address
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Address Line | 2482 BRIGHTS PIKE
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City | MORRISTOWN
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State | TN
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Zip | 37814-6315
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Country | US
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Telephone | 423-587-8771
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Fax | 423-587-8773
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Authorized Official
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Title or Position | PRESIDENT
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Name | RANDALL FRYE
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Credential |
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Telephone | 276-494-8119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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License Number | L000000006169
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 0000000010
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License Number State | TN
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