MEDICARE: PREMIER HHC AGENCY 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1205799723
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIER HHC AGENCY LLC

Provider Business Mailing Address
First Line	:	3528 E 3RD ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-4648
Country	:	US
Telephone Number	:	317-439-6105
Fax Number	:

Provider Business Practice Location Address
First Line	:	3528 E 3RD ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-4648
Country	:	US
Telephone Number	:	317-439-6105
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	MS. TRACEY L HARRIS
Credential	:
Telephone Number	:	317-439-6105

Provider Enumeration Date	:	12/03/2025
Last Update Date	:	12/03/2025

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