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General NPI Number Information
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NPI Number | 1245397884
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Entity Type | Organization
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Legal Business Name | PREMIER HOME CARE AGENCY, INC
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1305 RAMSEY ST SUITE 203
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City | FAYETTEVILLE
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State | NC
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Zip | 28301-4403
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Country | US
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Telephone | 910-822-2540
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Fax | 910-483-1334
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Provider Business Mailing Address
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Address Line | PO BOX 2726
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City | FAYETTEVILLE
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State | NC
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Zip | 28302-2726
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Country | US
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Telephone | 910-822-2540
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Fax | 910-483-1334
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Authorized Official
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Title or Position | CEO
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Name | MARY V MCLAURIN
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Credential |
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Telephone | 910-822-2540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HC3505
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License Number State | NC
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