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General NPI Number Information
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NPI Number | 1982602207
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Entity Type | Organization
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Legal Business Name | PREMIER HOMECARE SUPPLIES, LTD
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Dates
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Enumeration Date | 07/11/2005
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Last Update Date | 10/19/2011
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Provider Practice Location Address
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Address Line | 8048 S KEDZIE AVE
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City | CHICAGO
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State | IL
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Zip | 60652-2603
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Country | US
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Telephone | 773-776-9941
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Fax | 773-776-9953
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Provider Business Mailing Address
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Address Line | 8048 S KEDZIE AVE
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City | CHICAGO
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State | IL
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Zip | 60652-2603
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Country | US
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Telephone | 773-776-9941
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Fax | 773-776-9953
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. TONY ZAKHEM
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Credential |
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Telephone | 773-776-9941
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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 | 5778
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License Number State | IL
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