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NPI Code Detail

MEDICARE: PREMIUM HOME HEALTH CARE INC

MEDICARE: PREMIUM HOME HEALTH 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
1251E00000XHome Health AgencyMI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2710100000E898OTHERMIBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1467452748
Entity Type Code : Organization
Provider Name (Legal Business Name) : PREMIUM HOME HEALTH CARE INC
Provider Business Mailing Address
First Line : 2015 15 MILE RD
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48310-4864
Country : US
Telephone Number : 586-276-0604
Fax Number : 586-276-0614
Provider Business Practice Location Address
First Line : 2015 15 MILE RD
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48310-4864
Country : US
Telephone Number : 586-276-0604
Fax Number : 586-276-0614
Authorized Official
Title or Position : PRESIDENT
Name : MRS. TRINIDAD CUEVAS ALAIR
Credential :
Telephone Number : 586-276-0604
Provider Enumeration Date : 07/28/2005
Last Update Date : 07/21/2022

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