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NPI Code Detail

MEDICARE: PREMIER HEALTHCARE SERVICES, LLC

MEDICARE: PREMIER 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
1251E00000XHome Health Agency550001589CA

General Provider Information

NPI Number : 1598077364
Entity Type Code : Organization
Provider Name (Legal Business Name) : PREMIER HEALTHCARE SERVICES, LLC
Provider Business Mailing Address
First Line : 400 INTERSTATE NORTH PKWY SE STE 1600
Second Line :
City : ATLANTA
State : GA
Zip : 30339-5047
Country : US
Telephone Number : 470-464-8000
Fax Number :
Provider Business Practice Location Address
First Line : 338 VIA VERA CRUZ
Second Line : SUITE 210
City : SAN MARCOS
State : CA
Zip : 92078-2645
Country : US
Telephone Number : 760-744-0200
Fax Number : 760-744-0215
Authorized Official
Title or Position : CHIEF LEGAL OFFICER
Name : SHANNON DRAKE
Credential :
Telephone Number : 470-464-8000
Provider Enumeration Date : 07/09/2010
Last Update Date : 03/01/2024

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Directions to “PREMIER HEALTHCARE SERVICES, LLC ” Practice Location

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