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General NPI Number Information
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NPI Number | 1780453688
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Entity Type | Organization
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Legal Business Name | PREMIER HOME HEALTH, INC
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Dates
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Enumeration Date | 12/20/2023
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Last Update Date | 12/20/2023
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Provider Practice Location Address
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Address Line | 200 E 7TH ST STE 200A
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City | LOVELAND
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State | CO
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Zip | 80537-4864
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Country | US
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Telephone | 970-893-7030
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Fax |
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Provider Business Mailing Address
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Address Line | 200 E 7TH ST STE 200A
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City | LOVELAND
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State | CO
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Zip | 80537-4864
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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 | JONATHON TEVIS WILDER
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Credential |
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Telephone | 704-896-5782
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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 |
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License Number State |
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