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NPI 1255313748

NPI 1255313748 : PREMIER HOME CARE, INC. : LOUISVILLE, KY

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General NPI Number Information
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    NPI Number           |    1255313748
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    Entity Type          |    Organization 
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    Legal Business Name  |    PREMIER HOME CARE, INC. 
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Dates
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    Enumeration Date     |    11/18/2005
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    Last Update Date     |    10/15/2025
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Provider Practice Location Address
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    Address Line         |    2195 WATTERSON TRL 
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    City                 |    LOUISVILLE
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    State                |    KY
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    Zip                  |    40299-2437
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    Country              |    US
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    Telephone            |    502-491-5243
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    Fax                  |    888-678-7190
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Provider Business Mailing Address
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    Address Line         |    555 E NORTH LN STE 5075 
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    City                 |    CONSHOHOCKEN
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    State                |    PA
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    Zip                  |    19428-2490
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CCO
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    Name                 |     WENDY  RUSSALESI 
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    Credential           |    
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    Telephone            |    484-246-9499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    332B00000X
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    Taxonomy Name        |    Durable Medical Equipment & Medical Supplies
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    License Number       |    199493
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    License Number State |    KY
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Taxonomy #2
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    Taxonomy Code        |    335E00000X
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    Taxonomy Name        |    Prosthetic/Orthotic Supplier
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    332BX2000X
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    Taxonomy Name        |    Oxygen Equipment & Supplies (DME)
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    License Number       |    909286
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    License Number State |    KY
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