MEDICARE: PREMIUM HEALTHCARE SERVICES, 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1417216920
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIUM HEALTHCARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	2234 S. HAMILTON RD
Second Line	:	STE 101
City	:	COLUMBUS
State	:	OH
Zip	:	43232-4389
Country	:	US
Telephone Number	:	614-501-3034
Fax Number	:	614-501-3035

Provider Business Practice Location Address
First Line	:	2234 S HAMILTON RD STE 101
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-4389
Country	:	US
Telephone Number	:	614-615-2736
Fax Number	:	614-501-3035

Authorized Official
Title or Position	:	ASST. ADM
Name	:	HENRY C JAMES
Credential	:	RN
Telephone Number	:	614-501-3034

Provider Enumeration Date	:	05/04/2012
Last Update Date	:	04/21/2026

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