MEDICARE: PREMIER HOSPICE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1124561055
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIER HOSPICE LLC

Provider Business Mailing Address
First Line	:	2011 TUCUMCARI DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77090-2051
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4606 FM 1960 RD W STE 675
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77069-4629
Country	:	US
Telephone Number	:	832-610-9733
Fax Number	:	346-998-1662

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	VARFEETA SIRLEAF
Credential	:
Telephone Number	:	832-610-9733

Provider Enumeration Date	:	11/25/2016
Last Update Date	:	06/18/2020

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Directions to “PREMIER HOSPICE LLC ” Practice Location

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