MEDICARE: PARAMOUNT SECURITY BUREAU, INC. DBAPSB HOME CARE AGENCY

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1306055066
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARAMOUNT SECURITY BUREAU, INC. DBAPSB HOME CARE AGENCY

Provider Business Mailing Address
First Line	:	12814 149TH ST
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11436-1920
Country	:	US
Telephone Number	:	718-659-6764
Fax Number	:	718-659-6760

Provider Business Practice Location Address
First Line	:	12814 149TH ST
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11436-1920
Country	:	US
Telephone Number	:	718-659-6764
Fax Number	:	718-659-6760

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. SOLOMON EDOBOR
Credential	:
Telephone Number	:	718-659-6764

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	08/22/2020

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