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General NPI Number Information
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NPI Number | 1497411847
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Entity Type | Organization
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Legal Business Name | PREMIER QUALITY HOME CARE LLC
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Dates
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Enumeration Date | 11/10/2021
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Last Update Date | 11/10/2022
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Provider Practice Location Address
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Address Line | 320 BROOKES DR STE 210
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City | HAZELWOOD
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State | MO
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Zip | 63042-2740
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Country | US
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Telephone | 917-776-2187
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Fax |
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Provider Business Mailing Address
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Address Line | 320 BROOKES DR STE 210
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City | HAZELWOOD
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State | MO
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Zip | 63042-2740
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Country | US
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Telephone | 314-274-2776
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. RASHAD J PREVILLON
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Credential | NP
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Telephone | 314-274-2776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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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 |
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License Number State |
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