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General NPI Number Information
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NPI Number | 1447442926
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Entity Type | Organization
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Legal Business Name | PREMIER HOME HEALTHCARE, INC
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Dates
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Enumeration Date | 08/17/2007
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Last Update Date | 01/19/2012
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Provider Practice Location Address
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Address Line | 209 DUNLAWTON AVE UNIT 9
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City | PORT ORANGE
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State | FL
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Zip | 32127-4472
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Country | US
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Telephone | 386-767-0903
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Fax |
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Provider Business Mailing Address
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Address Line | 209 DUNLAWTON AVE UNIT 9
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City | PORT ORANGE
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State | FL
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Zip | 32127-4472
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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 | PRESIDENT
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Name | TIMOTHY B BATES
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Credential |
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Telephone | 386-767-0903
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State | FL
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