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General NPI Number Information
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NPI Number | 1942099692
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Entity Type | Organization
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Legal Business Name | PREMIUM STANDARD HOME HEALTH OF ALABAMA INC.
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Dates
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Enumeration Date | 04/30/2025
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 605 US HIGHWAY 29
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City | VALLEY
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State | AL
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Zip | 36854-4172
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Country | US
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Telephone | 317-453-6323
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Fax |
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Provider Business Mailing Address
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Address Line | 2231 HUNTERS GREEN DR
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-5182
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Country | US
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Telephone | 317-453-6323
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. GIANINA WALKER
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Credential |
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Telephone | 404-545-6888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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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 | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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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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