MEDICARE: PREMIUMCARE LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251J00000X	Nursing Care Agency
2	251E00000X	Home Health Agency
3	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1427734300
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIUMCARE LLC

Provider Business Mailing Address
First Line	:	11336 RIVERBURY CT
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92505-5161
Country	:	US
Telephone Number	:	424-215-1580
Fax Number	:

Provider Business Practice Location Address
First Line	:	11336 RIVERBURY COURT
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92505
Country	:	US
Telephone Number	:	424-215-1580
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AARON SANDERS
Credential	:
Telephone Number	:	424-215-1580

Provider Enumeration Date	:	06/26/2023
Last Update Date	:	04/10/2026

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