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NPI Code Detail

MEDICARE: PREMIUM SELECT HOME CARE INC

MEDICARE: PREMIUM SELECT HOME CARE INC
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
1385H00000XRespite Care
2251E00000XHome Health Agency097050DC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437289840
Entity Type Code : Organization
Provider Name (Legal Business Name) : PREMIUM SELECT HOME CARE INC
Provider Business Mailing Address
First Line : 5513 ILLINOIS AVE NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20011-2937
Country : US
Telephone Number : 202-882-9310
Fax Number : 202-882-9374
Provider Business Practice Location Address
First Line : 5513 ILLINOIS AVE NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20011-2937
Country : US
Telephone Number : 202-882-9310
Fax Number : 202-882-9374
Authorized Official
Title or Position : ADMINISTRATOR
Name : MRS. LINDA HART DAVIS
Credential : R.N., M.S.
Telephone Number : 202-882-9310
Provider Enumeration Date : 03/06/2007
Last Update Date : 03/05/2020

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Directions to “PREMIUM SELECT HOME CARE INC ” Practice Location

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